HomeMy WebLinkAboutPermit Electrical 2008-10-1
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225 FIFTH STRE;ET " SPRINGFIELD, OR 97477 . 'PH:(541)726-J753 . FAX: (54])726.3689
ELECTRICAL PERMIT APPtICATION
City Job Number /J' q- /"J ,) -<: Date
Signature of Supervising Electrician
'~P--1 ,/~ ~~: ~::::tionor Extension Per pane,/ $ 48,00
, ~ " ~ Each AddItional CIrcuit or with -
'~ '{\.\ '" .~ ServIce or Feeder PermIt $ 4,00
Owners Name A f\1.\...)
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LEGAL DESCRIPTION:
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JOB DESCRIPTION: .' l? ~l
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Permits are non-transferab)e-;;"nd expire if work is
not started within 180 days of issuance. or if work is
Suspended for 180 days.
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2 ~iCONTRAGTORiINSTALI1ATION:ONLYili'
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Electrical'Contractor E/4515/fJr::. fLfCTf(,(
Ad<Jres~ 31; ;)S"3, Bos CAGe" (../0 SP~lO
City
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Phone 7 if I: I V '7 9
Expiration Date
Y7)"7'S
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Supervisor License,Number
Canstr. Ccntr,_Number
117770
I 0-/ - 0 If
Expiration 1!ate
OWNER INST ALLA nON
The installation is being made'on property I own which
is not intended for sale, lease or rent.
Owners Sig~ature:
Inspection Request: 726-3769
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Service Included
1000 sq, ft, or less
Each additional 500 sq, ft, or
portion thereof
Each Manufact' d Home or .
Modular Dwelling Service or
Feeder
$1 ]7,00
$ 21.00
$55,00
B.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps'
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 70,00
$ 83,00
$138,00
$180,00
$413,00
$ 55,00
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
$ 55,00
$ 76,00
$110,00
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Pump or irrigation $ 55.00
Sign/Outline Lighting $ 55,00
Limired EnergylResidential $ 28,00
Limited Energy/Commercial, $ 50,00
~'pnimum Electric Permit Inspection Fee is $50.00
4.
8.% State Surcharge
10% Administrative Fee
5% TechnologyFee
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TOTAL
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Shared Dnve(T )/BUlldUlg Fonns/Electncal Penrut A.pphc::Jllon 7-07 doc
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