HomeMy WebLinkAboutPermit Electrical 1991-3-1
225 FIFTH STREET
.SPRINGFIELD, OREGON 97477
. .INSPECTION REQUEST: 726-3769
OFFICE: . .726-3759
1. LOCATION OF INSTALLATION c>L
.. lOll roC) 11\ XI
ELECTRICAL PERMIT APPLICATION
City Job Number . ql()\~ r:+--..
3.
COMPLETE FEE SCHEDULE DELOV
LEGAL DESCRIPTION
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
2. CONTRACTOR INSTALLATION ONLY D. Services or Feeders (10 Dranch.Circuits
~\\ 1)- included). Installation, Alterations
. Electrical contractor\'\\'.!XQ(\?io~ or Relocation:
Address.'VO ~t).L \ \ \. 100 amps or less
1."'\,,- \U- 'l . -LA A "'A Q 101 amps to 400 amps
Ci ty.\~ QY\)\\ Qyhone ~\O "II T\ 0 401 amps to 600 amps
601 amps to 1000 amps
Supervisor License Number ~~q LoS Over 1000 amps/volts
- ~ :0.. ~.sb.L DI{a 2- Reconnect Only
8:-- =rr- ~ 1-/
t_ D<.. r--r--.... ~ ... C. Temporary Services or Feeders
Constr Contr. Number \J2 ~~~ Installation, Alteration or Relocation
3/ [3{!lJ
, ,
... JOD ~E:~PTI01 ~ (\ 1 ~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
Expiration Date
Expiration Date
Figna~f Supervising Elec:rician
'{ j) /~ra=:C1 . .
.. bw~ers Name <:::>..~ .
Address 2.cL{) \' -;-:~ <?3t . .
. City>4)fl(\ . PhoneI4b-g4~1
. O~ INSTALLATION
The installation is being. made on
proper ty I own which is no t in tended
. for sale, lease or rent.
Owners Signature:
~A~~~-------~-~-~~)t---------------
RECEIPT I: J, . /q(<<s W
RECEIVED DY: I,\:jLL~~.......--
1500 sq;ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps.
Over 600 amps or 1000
D.
Dranch Circuits
Items
volts
Cost
Sum
$ 85.00
$ 15.00
$ 35.00
$ 35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
$ 35.00
$ 40.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
One Circui t
.Two .to ten Circuits
Each Addt'l ten or
portion thereof
5.
SUDTOTAL OF ADOVE
5% State Surcharge
TOTAL
E: Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limited energy panel
$ 35.00
$ 50.00 .~r)
$ 15.00
not included).
$ 36.00
$ 36.00
$ 36.00
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