HomeMy WebLinkAboutPermit Electrical 1995-11-3
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
. OFFICE: 726-3759
97477
726-3769
1. LO~ff1 O\\i9AL~fQI ~IY
LEG:\-ff)lf5t~D r'J)9J[) IT .
~~~:,~~~.~ ~:~"~::
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days,
2. CONTRACTOR INSTALLATION ONLY B.
Electrical contl.'actoS\Q~\-n ?~
Address.\~<70 ~~~1\t\. I St- ~ .
City rl"'.O.~ ~one~\
supe~ense Number OC\\1.S
Expiration Date \O.\.~':l>
Constr Contr. Number L{1~a3
~.?~,0\n
Expiration Date
Signature of Supervising Electrician
rJJJG0 ~~
Ovners Name(~ N'no~
Address \2fle~(ll'~
^, ~11('1:l-\t. C::4,"'OVe. ~a"t50
City II~ ~\ Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
OYners Signature:
~~TE~------~---7r--------r7~-~--
RECEIPT !:~I\"" .~
RECEIVED Bn-I )ULLA ~ \'-\~\""--
~l .
ELECTRICAL PERMIT APPLICATION
qQ\~ l
COMPLETE FEE SCHEDULE BELOY ~
Nev Residential-Single or
Mul t i-Family per dvelling uni t. . .
Service Included:
Items Cost Sum
Ci ty Job Number
3.
A.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular'Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to. 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 85.00
$ 15.00
$ 40.00
\ $ 50.00 ~
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see liB" above
D.
Branch Circuits
.'
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit ~
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00 1.Cl
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
~D.~_
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