HomeMy WebLinkAboutPermit Electrical 1999-1-28
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8.oeC/~:8t~e" ELECTRICAL PERMIT ~PLICATION
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q""l~ Job Number
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97477 <9,,'it.
726-3769 q'e
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION Auto~
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JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days. "
FEE SCHEDULE BELOY
sidential-Single or
Mu i-Family per dyelling
Service Included:
It ems
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .Dyelling
Service or Feeder
uni t.
*
Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
2. CONTRACTOR INSTALLATION ONLY .B. Services'or Feeders
, . ATTifnsta11ati(on, Alterations
Elec t ri ca 1 Con t r ac tor ~A~<::;"'1nL.~n, ('\(tollo\o ':u/gi ~8Sa~~j?orh'jlW requires you to
-.) , I'JOtificatiol1 Cent'; a by the Oregon Utility
Add ress L;;6J I') Chr {"--\?<Jl2d . in OAR4,09>.(ffllPs'~oIhq'~iS!lJleS are SAt fnrn$ 50.00
_ 0090. )Z~A~,a'")~Y tp tt4'00gamrAA Q<;?n')l.'$ 60.00
Ci ty t" \ .rA-5' f\(' . Phone '-t~5- 5'5 4( n ca"i40~ ~plPt't16 (6.~03,aI!1P!h" ",,-- b $100.00
v .f I numbbOfeatnPSelt6Na,OO~h?l'!Il&^h_~~ Y$130.00
Supervisor Li cense Number ..., J 5 'OY~e'flt1t060e@lJlPlil('1!~~ati'j -.:- $300.00
1911.11.1 R\'~8lfiiE,-ct'E01)~Y.32_2344). Ga"il" $ 40.00
Expiration Date VI"!
Constr Conte Number ?-.CJ- d:b5c:...l..S
Expiration Date_ 10- 1- '1'1.
Signature of Supervising Electrician
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Oyners Name"'Z\",..,\rw. tf(~"""I(, Y)
Address i.}/I C. 'K.\-j) St
Ci ty ~'ArJ~ Phone2H~- 5."Y)\
OYNER INSTALLATION
The installation is being made on
property I oYp. vhich is not intended
for sale, lease or rent.
OYners Signature:
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RECEIPT *:. l )-<,~A\tl
RECEIVED BY: V< -ffl .(A....--r .
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps.'oT less
201 amps to 400 amps
.'P'-"'..Q'L.er 401 to 600 amps
Over 600 amps or 1000 vol ts see "B" above.
ql\11T SHALL EXf?1 ~
D. Branch\ICircui f/s./FTHE WORK
"J/ Ut"TH
IS PERMIT Ie:; m1:
Ney, AlterationONor Ex'timsion Per Panel
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One Circuit $ 35.00
Each Additional
Circuit or yith Service
or Feeder Permit
$ 40.00
$ 55.00
$ 80.00
,.
$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting----L- $ 40.00 l/(').CO
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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