HomeMy WebLinkAboutPermit Electrical 1997-2-21
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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AutilOiized Signature
1. LOCATION OF INSTALLATION
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ELECTRICAL PERMIT APPLICATION
City Job Number C3,/c:>2g/
COMPLETE FEE SCHEDULE BELOV
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3.
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
LEGAL DESCRIPTION
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JOB DESCRIPTION
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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.
Sum
It ems Cos t
1000 sq.ft. or less
Each additional 500
sq. f t or port ion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Son it ro I Secu r i ty or Relocation:
Address P.O. Box 21009
City Euuene Phone 461-5678
Supervisor License Number ./...ftl2:3 R.~T
Expiration Date /0-/- 99
Constr Contr. Number 65149
Expiration Date-c."": 000" 7/z00()
Signature of Supervising Electrician
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Ovners Name rYlat"n 51. ,ltuJI'/nl
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Address~rY>~
Ci ty
Phone 744 -9ro:9
OVNEH INSTALLATION
The installation is being made on
property I own which is not intended
for sale. lease or rent.
Owners Sigl13ttlre:
---------------------------------------
DATE: -:::?-':< /-<7::>
RECEIPT ff: ~o~
RECEIVED BY'.c~_- .. .
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
S 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 1000
$ 40.00
$ 55.00
$ 80,00
volts see I'BII above
D.
Branch Circuits
Nev, 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 vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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$ 35.00
$ 2.00
no t i neluded)
$ 40.00
$ 1.0,00
S 20.00
S 36.00
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