HomeMy WebLinkAboutPermit Electrical 1995-7-26
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SPRINGFIELD
zo . 0 OWing project as sub .
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1. LOCATION Of iINSTf.~I1'JI2R",
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LEGAL DESCRIPTION
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ELECTRICAL PERMIT APPLICATION J
City Job Number Q ~()Rcj,
v .. , I
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
..,
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling
Service Included:
uni t.
Items
Cost
Sum
~ff&(
Permits are non-transferable and expire
if work is not started withip. 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor~~ ~
Add'ress ~ tD,lo'Z.j,p (' 0 OC\ \\ ~ ~
Ci t~h.~~ ~ 0 Phone l~
Supervisor License Number ~~
Expi ra t ion Da te \(') . \ qs
Cons 0' Contr. Number ~~ 10
Expiration Date """'1" \4 .~ 'J
$ 85.00
1000 sq.ft. or less
Each additional 500
:sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
B.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00 tfD,(5[)
$ 55.00
$ 80.00
see "Bft above
200 amps or less -i---
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Signature of Supervising Electrician
'-~,;,.~~~
Owners Name S aJJI.
Address
, Ci ty c::; r~
OVNER INSTALLATION
Branch Circuits
D.
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 2.00 .
..
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ltG .()C)
5% State Surcharge 7.c.JLJ
3% Administrative Fee , , 7 (,
TOTAL U;!2.,. 7 (7')
; -
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
----------------------------2:----~----
DATE: '1 ::7~n-q v,..I
RECEr'PT 11: ' rVl-\VJ - .
RECEIVED BY: . 11JVV"