HomeMy WebLinkAboutPermit Electrical 1997-1-14
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,'" 225 FIFTH STREET 0,,,.-1- ~fr
SPRINGFIELD, OREGON 9747.7!he,;zed Signaturo ~,h/J 1/ /f _
INSPECTION REQUEST: 726-3769 ~: Glty Job Number
OFFICy":,,...J26-3JI>9 J ~
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1. LOCATION, Of .!N,S:rALjJ.'}.}ON
, ~~/vr,V;l~
LEGAL~DE~TION
17D Jd,(o /5t7b7tJn
ELECTRICAL PERMIT APPLICATION
q 7 ()02CO
3.
COMPLETE FEE SCHEDULE BELO~
Nev Residential-Single or ~.
Multi-Family per dvelling unit,
Service Included: , ....
Items Cos t ~ Sum
A.
,I JOB DESCIq:.J'TION !?/ d -+- (]) ..,l000 sq. ft. or less
C:/I/?t.f'4e:;::;>> -}!Y'OJ0t4 f /00 /0 t, (}t{Y'~rrach addi tional 500
(J' sq. ft or portion
Permits are non-transferable and expire thereof
if york is not started vithin 180 days 'Each Manuf'd Home, or
of issuance 01' if "ork is suspended for Modular, 'Dllelling
180 days. Service, or Feeder
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor t.-i-rF: ~,
Address _fJ,o, /!JD'-X
Ci ty Ei./b.
Expiration Date
/ // 30J
Phone 1"L Cj oqr:l-t
?5 c;; 5
!o -qf'
517 -It
/;I) c:; -'17
Supervisor License Number
Constr Contr. Number
Expiration Date
Signatu~ ~:erv~~ctrician
Ovners N~e ~~ IJ1 t1 /jpiz,
Address ?-e}(}~ 'tvcold eeL
City ~ t,((3Phone
011NER IN~LLATI~N
The, installation is being made on
property I ovn vhich' is not intended
for sale, lease or rent.
Ovners Signature:
DA~~~=~(:7o~~~-~----------------------
RECEIPT #:,!:iH 2 7'1
RECEIVED BY:-*
.....
,B.
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
C.
$ 85,00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Nell, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit i
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
55 AJO
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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