HomeMy WebLinkAboutPermit Electrical 1992-9-21
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225 FIFTH STREET "qUIre specmLlilP.lil)t~M1gPERHIT APPLICATION
SPRINGFIELD, OREGON 97477 ZOning LDf2.. '( ~
INSPECTION REQUEST: 726-3769 t"" ,_~ ~i ty Job Number q 7.- I ~/ \0
OFFICE: 726-3759 "" ,_,
, $-" f - ''''':Zed Signature3. OMPLETE FEE SCHEDULE BELOI/
1. LOCATION OF INSTALLATION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
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Address it; 0 \ --p<,<~,
City
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Phone '5 '-( 20 I 3 I ')
.) Supervisor License Number 5'5 S~ 2.. ::J LC:-
Expiration Date
/0 -- 1- "73
Constr Contr. Number sc, '1'1<{
Expiration Date
'1-7<7- Cj -.,
Signature of Supervising Electrician
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Ovners Name U"'-~ + fJ ~ k_ /1( 1/0.''--\
Address
Ci ty Phone 7'1 7 - 6] '1'/
OI/NER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
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Ovners Signature:
----------------<5------~--------------
DATE: ()- 2-,1-~( Z' "
RECEIPT~: 104i9 ':J
RECEIVED BY: (.VV
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S."IIIN(.,;.FII;L.U
A. Nev Residen Single or
Multi-Family per dvelling uni t.
Service Included:
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
B. Services or Feeders,
Installation, Alterations or
Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ BO.OO
volts see "B" above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lightin~----- $ 40.00
;X:Limited Energy/Res Ie $ 20.00 'Zo.c,cC>
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
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