HomeMy WebLinkAboutPermit Electrical 1998-12-8
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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LOCATION OF INSTALLATION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of' issuance or if work is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
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Expiration Date
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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Owners Signature:
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RECEIVED 'BY: ~{/')(}::-) ~'-
ELECTRICAL PERMIT APPLICATION
City Job Number q?,/ L/1 (0
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COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
A.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
,B. 'Servj ces or Feeders
Installation, Alterations
Electrical Contractor J- 5;t-:I/'.-If" ~{'<A--<uIi../Y-<. or Relocation:
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Address 0.6 (S()\ ;)16'33 ,\.fOl!oVvr~tl0A'oQ)lGmps or less $ 50.00
6!f:! i t-",iCatio eS2;Q<~,oil~/a\9~400 amps $ 60.00
Clty ('U n. ~ Phone l'i0 _!flF:H."9 nc.~~ ~o~0;e"~s $100.00.
. J'~ ~~o S2'006%, iitji:li,.~?eq~~ ~iP $130.00
Supervisor License Number :! (', -;}<f ~lin17 ~hf11ay(b'br;J.o~g 8!frt>SJfIl?; iJitl/ $300.00
"Uf11b e ce~1il!iffi~F. 6~ 9 et fOrth-- $ 40.00
J (', -1- 0/ e~:fortheoer.(lVote.eSOfthe S2-o07.
-eftteri T'lfft)o.f~~'l/;/.hS~!'t,l;&!f1S~ Feeders
Constr Contr. Number '7 ()J',f 7,...,. ~h!i~~~Ii'O'\btiiJ.!If'ltlu:ation or Relocation
~v'!J I{;f' '2'23441 ICation
Expiration Date /2 - 30' 9R:iieon__ . 200 amps"oT 'less $ 40.00
. A . -, '-nlVII (SHALL b2.0J amps to 400 amps $ 55.00
Signature of Supervising Electr.i'clii!l.'/ZEDlJN O'vEit.'E"9lfhto~p~Lamps $ 80.00
if ^ /. / COM,MENC D, ER o.v,!U'P~g~rrmps'lifr 100u VOl ts see "B" above
-----+-_ ~ j)~ .. ED OR'S Ap'dAln IS NOT
P ,.., ,f" 11.,y PFr:Pi Bran'2h'EQ~U:,ili ts
Owners Name (.l A--~ J f!.l {,.(..-- I( '1
n. ./ New, Alteration or Extension Per
Address .r7.}, rvUJiA ..::--;-
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City 5p(h-f....uJ Phone ~'O-PbOr
OVNER INSTALLATION
Items
Cost
Sum
$ 85.00
$ 15.00
$ 4().00
"
1-
Panel
$ 35.00 ~
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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