HomeMy WebLinkAboutPermit Electrical 1998-11-5
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225 FIFTH STREET "'I)~~:: "",/1- "l-- ''I9~!~LECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 .s:j;,," "v.. 'VIa.~., .
INSPECTION REQUEST: 726-3769 '~''''''~. I ~ ~ tY}'Job Number qR/'ZJ;; <
OFFICE: 726-3759 "--..~
1. LOCA~~~~STAL>>P)J;CC7t~ Iff. 3. C::P~::d:::i:~:~:eB:~OYunl't. ,~. \,
Mu '-Family per dwelling .
LEGAL DESCRIPTION Servl e Included:
/'/_'3. 7"'/c"I' c::7b/t?&> Items Cost Sum
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JOB DESCRIPTION
p'm"'1'I7 ,/C?/' )/, {/AC 0m?p>
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~~~ ..
-..;;;. '.J ../ 1
Address
City
Phone
Supervisor License Number
Expiration Date
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations
or Relocation:
$ 85.00
$ 15.00
$ 40.00
200 amps or less $ 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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name c..A~ ~~j)
Address 2'7 ':::;''3' .~~ / ~
Ci ty h~L7j...?~" Phone~5'e ~9;SilpY
OIINER INSTAL2~.
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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..?-"""DATE: /t.- ~
RECEIPT II: 3/"~
RECEIVED BY: /' ~ - --
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200 amps"oT less .
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see fiB" above
"
New, Alteration or Extension Per Panel
One Circuit ~$ 35.00 ~~.'--
Each Additional
Circuit or with Service
or Feeder Permit I $ 2.00 ~.~
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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