HomeMy WebLinkAboutPermit Electrical 1998-10-13
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
ELECTRICAL PERIlIT APPLICATION
Ci ty Job .Number q 'I {f! (/J ()
3. ~
1. LOCATION OF INSTALLATION
f) J rYlQ ,'/\ ~. A. Nev Residential-Single or .
dO / 7D2?) J/O)).tJ"" Multi-Family per dvelling unit, ~ <.
LEGAL DESCRIPTION ~j~ ~ Service Included:
~?'i 0 ~Q_ 'funK Items Cost .' Sum
,...,--JOB DESCRIPTION ' 1000 sq.ft. or less $ 85,00
,jN\~O 0 t nr;, <v.or i I n d~L,L Each addi tional 500 to
u sq, f t or rI1RfJ1ili>qn\leS ~Oll, .
Permi ts are non-transferable and expire ENIIGIll~lflgo t\'l80legooUtllltY $ 15,00
if vork is not started vithin 180 days i>-ii ~Q9~~ flIllIllSJilfe.."tlert\"l
of issuance or if vork is suspended for 10110W 'MI\~ill. b\1S oi>-R 95Z-001-
180 days, Notiliea~rOO.'clY06~ l5e~~IQIt\"le lilies b% 40,00
10 Qi>-R II (11a~ obtalO e I' . \"Ie telepnu""
2. CONTRACTOR INSTALLATION ONLY o~~O. f~t'tJ}qj{S\te1t tlllg~e~~(ifNotilieatioO
eal Jlhfa0.\Illl aI\9l'ilPO$2~~ons
Elec tri cal Con trac tor So nit r 0 I See u r i t,Y~ oll(o" c;~I'i\;r\i.(l1l9-
200 amps or less $ 50,00
201 amps to 400 amps $ 60,00
NtOJ amps to 600 amps $100,00
6BjcaEps to 1000 amps $130,00
TH~v~r~lOOO amps/volts $300,00
AII"ec~n~4kt$I-fAf!!tXPI $ 40,00
, HOR/ZED UN RE IF THE 1M
CC()i~'J;Iir'p,pF;~ry ~gflv1iHJ~JftSA' R..eed2f1#'
~ ''IY Ins ta:nitlil\l8 ABANDera d6';,J&iro~e10ca t ion
. I RI) riA', PERI ONED FOR
200 amps o,o'less $ 40,00
201 amps to 400 amps $ 55,00
SiA"e o:Ju.'/7"'/7"iSi, E_lectrician. Over 401 to 600 amps $ 80,00
~ Over 600 amps or 1000 volts see ~B. above
"'met'/J ')' /ISlA r;,. ~ D, Branch Circuits
Ovners Name 11\.t-11 U I::..- CUUL-!-fI..f?/L
Addre s! 70 So. ).lv::{ .:!t:JOO Nev, Alteration or Extension Per Panel
7Jj)ry(' h One Circuit .$ 35,00
Ci ty{ J u..) g/!1J.)__ Phone Each Addi tional
If Circuit or vith Service
OVNER INSTALLATION or Feeder Permit
Address P,Q. Box 21009
Ci ty Euuene
Phone 461-5678 .
Supervisor License Number \ ( n~.~
Expiration Date \0101 \qq
Constr Contr. Number 65149
Expiration Dale..
6-28-00
The installation is being made on
property I ovn vhich is not intended
for sale. lease or rent.
Ovners Signature:
~~~~:~I'~j/~~;t~~;~-~-~-~----------
RECEIVED BY: 7" fr.I/A~
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$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40,00
Sign/Outline Lighting $ 40,00
Limited Energy/Res $ 20.00
Limi ted Energy/Comm $ 36.00 .~~rcJ
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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