HomeMy WebLinkAboutPermit Electrical 1997-6-20
,1
. ""1-.., f...tl_...'___
(II' I
Zordr:-.:.',_ lA..--./
Dt:1.0.&::lU::i!-
974 711Ulhorizod Slgnetur. N M
726-3769
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
I/)h';;;' m/Jr"n . <../
LEGAL llf:s.PUPTION
,703"5)4 I 1)4~
JOB DESCRIPTION
'";1 <;+It /! S,-'/ in', "+;
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
SPRI~GFIELD .
ELECTRICAL PERMIT APPLICATION
C. .\ 'tr"V'I,"'h.
.:.. L;t Job Nwnber '\ \l _ M, ).._,
3. COMPLETE FEE SCHEDULE BELOIi
um
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included: .
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
S 85.00
S 15.00
S 40.00
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 //029 f!E.T
Expiration Date /0- /-qq
Cons tr Con tr. Number 65149
Expiration Date 7-2000
S7~g
Owners Name 8rffhrtfl' l!ou<f'
Electrician
Address .:5::l/Jit'.
City ,Phone
01iNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or ren t.
Owners Signature:
~~~~~~~::~~~~~~-----------
RECEIVED BY: r\ \'\ --..... ,
'-".l\.\-
200 amps or less S 50.00
201 amps to 400 amps S 60.00
401 amps to 600 amps S100.00
601 amps to 1000 amps Sl30.00
Over 1000 amps/volts S300.00
Reconnect Only S 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
S 40.00
S 55.00
S 80.00
see "B" above
volts
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
S 35,00
S 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation S 40.00
Sign/Outline Lighting S 40.00
Limited Energy/Res S 20.00
Limi ted Energy /Comm I S 36.00 .3feE!?
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
3{oi5b
fEo
/ D"if
~ g ss