HomeMy WebLinkAboutPermit Electrical 2001-1-2
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225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
ELECTRICAL PERMIT APPLICATION
_ City Job Number CXJ ~0037V-OI
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225 FIFTH STREET zoning, and does f' /l.
SPRINGFIELD, OREGONal.J'l~"i'7. L/V'
INSPECTION REQUEST: 726-39'll'lJl 1- ),-0)
OFFICE: 726-3759 Date ~
1. LOCATION OF INSTMltlll't~fj,gnatule .
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LEGAL DESCRIPTION
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JOB DESCRIp;l'ION , /
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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
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name S""'A ~_ UA-I<:.<>----
,
Address .3 'if ~ 33 SA-sfHl.. Lovel!,Qd
City_ ~\~ Crt'=r'-(c Phone ~6 -"6327
OlINER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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~~---~---~~~~;;;;---------------
RECEIPT 11: '1/ t{ b
RECEIVED BY: ~ r<:.
v"r.<l.h...", FEE SCHEDULE BELOV
New Residential-Single or ~
Multi-Family per dwelling unit.. .
Service Included:
Items Cost '" Sum
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:
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
$ 60.00 '
$100.00
$130.00
$300.00
$ 40.00
C. 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 100u
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
......-
$ 40.00
$ 40.(JQ: -j
$ 20.00~~
$ 36.~~
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