HomeMy WebLinkAboutPermit Electrical 2006-4-26
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 . I J?it
ELECTRICAL PERMIT APPLICATION . /II A /Olp0Y'
City Job Number c..o~.?OOS-Dl-;S4 Date U r jA{I
I
3. COMPLETE FEE SCHEDULE BELOW
I. LOCATION OF INS1'ALLATION
lliy
t7D'"Z..3 Sl( I OIl{OZ Servicelncluded ~~
JOB DESCRIPTION 1000 sq. ft. or less . $106.00
"JAr. 11\... _ r~ _.I. -' '2,.,' ~ L & Each additional 500 sq. ft. or .
"wv ~ J- :;7I..AfCttlU IM~ portion thereof $ 19.00
Permits are non-transferable and expire ifwor~ ~ Each Manufact'd Home or . ou to
not started within 180 days of issuance or if work is Mod,!!larj)e\~\I~geel)\id':Oti reqUireS V llt'l't"$50 00
Suspended for 180 days. iF.-gjeN1\\ . d . ~d by the Or~:"n II, h .
101l0w ruleg a op h se rules are set 10rt
~-.ioti~,tr'J'.ic:.fS 6TEFfJeJerI - A?8d~rlt~~,r~ttef'at10'n\-or Relocation:
. OAR 952-001-0010 t . s of the rules by
IdOO-Amlli!lQnle~sobtain COple th- ,~lnhO'$t63.00 ~. 00
i'OJ~i\l;'~S\tQelOQ)A\1jPs lNotue:t'\'lt.: ~1,,\ifir.al$:J]J;.OO
1;'\1'" ':':' . nr gon \ j'
40IuAml1lltb;600lAmp~ 0332 MIlil.\ $125.00
n ."- . 1 80 - -.
601 AmpsliO'lfdOO ~mps $163.00
Over 1000 AmpslVolts $375.00
Reconnect Only $ 50.00
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits t WOR\<.
MQ1Wk~' terotioll'<\r E'ip.\fif~~~pl~paiid~OI
I~ ~ II ",,,.,, S ytliW\l1 .-
1\'1IS&ne <irc~i\JNOER 1\'11 nNEIJ ~r\p, $ 43.00
I\Ul\E~.\~tlbi\,qqil! ~r~ilf\MQftli ~ $ 3.00 q 00
.......... .J.I~... 1 J CO\'.servlc1l,tFeeiI~:t>\O'.r.lt . .
Owners Name ...llMOIVIL{..~llbYe.. ~\'.('1'BG Ol\'{ Pt\\ . .
Add'ress <RO. ~x. ~ O-r I\E. Miscellaneous (Service/feeder not included) -Each Installation
City ~+ Unn Phone~)"~1-7.S3z.,..
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LEGAL DESCRIPTION
2.
.CONTRAC'I'OR INSTALLATION ONLY
Electrical Contractor
5Ir3ve
lit! Ol.IL
Address
p. 0, 00)'
?-13h I
City
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Phone
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Supervisor License Number
~=11J
Expiration Date
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ConstT. Contr. Number )L( f hiP,
Expiration Date 1.-1- 30-01--
Signature of Supervising Electrician
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OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
A. New Residential- Single or .Multi-Family per dwelling unit.
C. Terl1porary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
$ 50.00
$ 69.00
$100.00
, .
Pump. or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fec is 545.00 + Surcharges
4. SUBTOTAL OF ABOVE
7.:). DO
.c;.7(P
7. .;;2 0
~
~!Yo State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building Forms/Electrical Pennit Application I-03.doc