HomeMy WebLinkAboutPermit Electrical 2002-10-29
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. 9 ?,o\ec' ~s,~"J"e s?eC' . ELECTRICAL PERMIT APPLICATION
974.7\iIOIlO",'\"Io ooes \"10 0
72fr,nr.!J9fj c: o'Z...- ' Y Job Number D? -0 710- d
a??'O 9 !'\... -
1.0\"1,\"1 10 ' ""~\I-C~EE SCHEDULE BELO\l
1. LOCATION OF INSTALLAt:!;.W' ,e ~ - .,
\ ",>\0 N""~"~!- s\. \~~~\\l&"t..' A. Nell Residential-Single or 6)
. ~U' Multi-Family per dlle11ing unit,
\f\tf~~~~TIOr\~ Service Included: Items Cost \()~;um
, $ ~ 9,5,"0
1000 sq,ft, or less
Each additional 500
Anl1i~H l@k8reg.9S,Ii:M>PeqUlres you tf$
fOlloll\thJle~21&O~~d~~the,Q,O - Jlility 15,00
~otifi~@~ ~'e~~ ~ 'tftif~luYes :r~ ~et forth
In OAR~It~~-( l:1~eraW1 OAR 952-0S1-40, 00
0090. :ou may obtain copies of me rules by
B .calg~:r~ti~esnb1f. ttellttet!$B telephone
nU~(Mt1"IHGJl!JgO~~'~rr-ltjt~Mation. 00
or @"'l!().c~t:l~.\,;il-832-2344), \..n; .
200 amps or less \ $ -sO 50,00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100,00
601 amps to 1000 amps----- $130,00
Over 1000 amps/volts $300,00
.Reconnect Only $ 40.00
() "\i\
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
JOB DESCRIPTION
AM.; ,"",6,..)
Permits are non-transferable and expire
if Ilork is not started Ilithin 180 days
of issuance or if Ilork is suspended for
180 days,
2, CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~"1 U II ~lO<;',
l1()\~A
City s~ncl . Phone...2l,-7.77Y
Address
Expiration Date
Constr Contr, Number
0/)~,..u: k.,
Address 2A~\ ~~Of\~ ~l~
Ci tY~l<<\.~O~ Phone 7<.1)- l!Nl.
OIlNER INSTALLATION
$ 40,00
$ 55,00
$ 80,00
see "B" above
"
Nell, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or Ilith Service
or Feeder Permit
$ 35.00
$
2,00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
The installation is being made on
property I olln Ilhich is not intended
for sale, lease or rent,
E.
OllTIers Signature:
DA~E~----\t):9C5.-~f)~----------------
RECEIPT 11:
RECEIVED BY: (\(\\<-
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
40,00
40,00
20,00
36,00
$
$
$
$
-0.5""
'\'.15
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