HomeMy WebLinkAboutPermit Electrical 1999-4-2
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approval use
225 FIFTH STREET . ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97 ;fl?ing
INSPECfION REQUES'J)l$e _7?h_1769 City Job NUJI1ber...!2$/~/
OFFICE: 726-3759Authoriz d S'
e 'gnature ,. COMPLETE FEE SCHEDULE BELOI/
B. Services or Feeders
r- Installation, Alterations
c\ectrf'ClYJ~. Relocation:
200 amps or less
201 amps to 400 amps
401 am~s to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPp:ON
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Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2,
CONTRACfOR INSTALLATION ONLY
Electrical Contractor~~
Addressi qS Mach::.on
City Eu~
Expiration
Phone 4 ~ s- CA2 2.
2- <t 1()-::\
Oate_ I(J- /-~I
Supervisor License Number
Constr Contr. Number 4?.C, {~
Expiration Date 12-/o-Qq
Signature of Supervising Electrician
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Ovners Name::;~_7/ M~7'.
Address47~/~~~ "'5~~_ ~~
City '"'iA/F~/~' Phone~~~~~6
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OI/NER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
KL(;L.lPT If:
RECEIVED BY:
7"'"2 ,~
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A.
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
,," ~
co~t . Sum
Items
1000 sq.ft, or less
Each additional 500
sq. ft or portion
thereo'f
Each Manuf'd Home. or
Modular 'Dvelling
Service or Feeder
$ 85.00
$ 15.00
.$ 40.00
/,,!
I
$ 50.00 ~
$ 60.00 ~
$100.00
$130.00
$300.00 ~
$ 40.00
/
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see IIBII above
D.
Branch Circuits
,"
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permit r~S" $ 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
Limited Energy/Comm $ 36,00
5, SUBTOTAL OF ABOVE ~..p#fP
5% State Surcharge /~.~
3% Administrative Fee 7b.sse>
TOTAL 2. 7t:'V , J!JC