HomeMy WebLinkAboutPermit Electrical 1996-6-25
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~LECTRICAL PERMIT WLICATION
City Job Number lA,\D1)~2.2-
2. CONTRACTOR INSTALLATION ONLY .B. . Services or Feeders
. Installation, Alterations
Electrical Contractor~ ~lfrtfiC\rt?F 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
225 FIFTH STREET Authortzed SIgnature
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
~~~~6f~9 t I f\.'^.t:JJ.Jd, 3. COMPLETE FEE SCHEDULE BELOII
1. lj:5'eA'ffoN l~J
\t)O' 6:- \? ~1tj i(L 'rJJiJJ' New Residential-Single or
i~ D.:, Lr-:./LI Mul ti-Family per dwelling uni t.
U;:GAL DESCRIRTIONf) \ .J~;.r..,J Service Included:
_'Pi \ \ h<yI,IV'_~ - \ ro 1-</\ Utr.e L-WY:' . Items
, .+QB DES~PTI~ _ . 1000 sq.ft. or less
UVo. v?'Hi-P ';'f"Y\J\ C ? Each additional 500
, J - sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home. or
of issuance or if work is suspended for Modular. 'Dwelling
180 days. Service or Feeder
.
Address~(01" ~{ ,
Ci ty t:'\ x::.("J)~ Phone 4<( S-OG2.L.
. '0 .
Supervisor License Number :J Cf ? 0,... S
Expiration Date. ~ Qf}OO-ID.I.q8'
Constr Contr. Number 20-\'1.<:' ~%c.
lS.\D.q(o .
Expiration Date
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Signature of Supervising Electrician
#yL 7f?~ '
Owners Name--3UJ}(A~'
AddressJI'fN ~ 3b.td
Ci ty f~1\~ Phone \.oR3.3'636
O\INER I~STALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
.
Ovners Signature:
DATE~~---------l[o-~~~ctrn--~~~~
RECEIPT II: ~
RECEIVED BY: ~~~
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00 e5lJ
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or,Feeders
Installation, Alterat'ion or Relocation
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D. Branch Circuits
.
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New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or with Service .9-
or Feeder Permit l $ 2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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