HomeMy WebLinkAboutPermit Electrical 1995-11-13
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ELECTRICAL PERMIT APPLICATION
225 FIPTH STREET
SPRINGFIELD, OREGON 97477 Locin" d LJi;?
INSPECTION REQUEST: 726-f~U;9 l { _I 3 _ c~ c:-
OFFICE: 726-3759 ---' ~
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. ,... .....:-.. :;:.ognatura
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
17~~'7?-Y2/~/~/3
, . '
/ JOB DESCRIPTION r- '72
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Permits are non-transferable a~~~~
if work is not started wi~hin 180 days
of issuance or if work is suspended for
180 days.
Af
A.
2. CONTRACTOR INSTALLATION ONLY
Elec t ri cal Con t rac tor ~""Y.N'~ E~_
r
Address :z?J!i?"2 c;;:.~L .~'!.O_
Ci tYtLr;;..~~.AY~ Phone Yo/~-;:>:2-:J::>
Supervisor License Number .:('''5"..:?'::::> 5-
Expiration Date /6~/~
Constr Contr. Number 172""L
Expiration Date
g.."5'-9~
Signature of Supervising Electrician
d:r/~~
ow~ N:me r.~:- ~T7-
Address !f??/ yr ~c::. ~/=-
City ""'5~c.O Phone~..,...y.:S'~
,
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
/1'/3."~
/ ~~&;;
~ .-..,.oJIl ., ~
City Job Number
~5"'"/?? 'I
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Seyvice Included:
Sum
Items Cos t
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular 'Dwelling
Service or Feeder $ 40.00
B.
Services or Feeders
Installation, Alterations
or 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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 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 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D.
Branch Circuits
"
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
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
40.00
40.00
20.00
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$ 36.00
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