HomeMy WebLinkAboutPermit Electrical 1993-12-3
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225 FIFTH STREET ".':'."':":::' . \ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97417' '. .'-c, C;"._0._....___..
INSPECTION REQUEST: 726-3769'c\,"\'~;; Ci ty Job Number C-/::<, if) 10 d-
OFFICE: . 726-3759 V'. ...~~_'2\-.. . Nl --
. . . "".0 .~_3. .-COHPLETE FEE SCHEDULE BELOV *
1. LOCATION OF INSTALLATION" .," , n' .....
S i 8 J VYI r,;~./ <:::.,-t r A. New Residential-Single or
Hulti~Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
Ii 1')'") '2.,2, 4) 1)2,<;06 Items Cost Sum
$ 85.00
\
JOB ~SCRlPT~OF ~ 1000 sq.ft. or less
9.JUJn.fl JV;r\ Cf!J..L11..!L') J - LIDO ,4-mp Each additional 500
. "':::.Lvv~u -r-3D 0In::.",;:n:-sq, ft or portion
Permits are non-transferable and expfre thereof
if work is not started within 180 days Each Hanuf'd Home or
of issuance or if work is suspended for Hodular Dwelling
180 days. Service or Feeder
$ 15.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor J I{ G
$ 50.00
$ 60.00 toO. 0()
$100.00
$130.00
$300.00
$ 40.00
Address ;::). 1 S 7 I Don
City~,JJ Phone 74~ ~t.. tib
supe-:J;~:?{icense Number ,,:?) 4 p;,s
Expiration Date 1(') -1-qS
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
Temporary Services or'Feeders
Installation, Alteration or Relocation
C.
Constr Contr. Number 4..(' I ;z q
Expiration Date J./ -;1 'I ~ q 4
$ 40.00
$ 55.00
$ 80.00
see "B" above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Signature of supervising Electrician .
qiM1JYW~ J>llupJf~iW\
.. Owners Name ~()/V'> ~f\MAr..'j~'
Address In'::!! IJ .6:t/lP1'/0
City ~ '7)../ v(> tCt ('~hone 70i -Ll-l./S-- 9&J1
OVNER' INSTALLATION Q~SO I
Branch Circuits
New, Alteration or Extension Per Panel
$ 35,00
One Circuit
Each Additional
Circuit or with Service
or Feeder' Permi t 30
$ 2, 00 ..kz.t2,00
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40,00
Sign/Outline LightinR $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 1-, 'JO, O~
5% State Surcharge (n.Ol)
TOTAL . J -:JL...O ()
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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DATE:
RECEIPT, I:
RECEIVED BY: