HomeMy WebLinkAboutPermit Electrical 1996-12-13
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:.,):1ing, and docs not roquire spec;nc lond use
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9'~l1'7'2"'1 Signature ^.' tlJj./!~LEcrFJ.CAL PERMIT APPLICATION
726-3769 Ci ty Job Number-% / 5, S 5'
,
225 FIFTH STREET
SPRINGFIELD', OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.' LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if ~ork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR . INSTALLATION ONLY
Electrical Contractor
/'
/
Address
City
~e
Supervisor
....
3.
COMPLETE FEE SCHEDULE BELOY
Items Cost
.
Sum
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
1000 sq.ft~ or less
Each additional 500,
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .Dvelling
Service or Feeder
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
$ 85.00
$ 15.00
: $ 40.00
$ 50.00
S 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date 200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Signature of Supervising Electrician Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Ovners Name~a.I Wcr.~
Address~7~~ ~AJ (~D
City ~, Phone~/-Jt:IJ
OYNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
tor sale, lease or rent.
Ovners Signature:
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RECEIPT j1: l' d ~.o~
RECEIVED BY:' /~-~
',IV
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permi t :z.
[..../' $ 35.00 3S... 00
$
+~
2.00
not included)
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
40.00
40.00
20.00
36.00
$
$
$
$
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