HomeMy WebLinkAboutPermit Electrical 1993-8-12
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'M\\lI"~9~I1-' ELECTRICAL PERMIT APPLICATION
97477 10\\d"r;o.Ooo U i').,.llnr;q
726-3769';r;o.\\'I\l~~. 0--. Ci t 0 Number q~
.,,99,0 ~O\'l\\'I\l .C\J
'. TE FEE SCHEDULE BELOV
1. ,.}..,~CATION M ~NSTALLATIQN ,r;o..:,.~e
GUc::.o (l..L{~{ (\ ) tl,,\0 ,..0",\0 A. New Residential-Single or
. ~ ON --- ~~~v' Hulti-Family per ,dwelling unit.
\fJ~~~")\ ~~~~~ Service Included: Items Cost
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
\ JOB DiSCRIPTION. lL-
(' " '\.. (' \.." ---.A' --,
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
Electrical Contractor~'.. =~c~ <=('~\c..
Address \.~,<:::::> ~ ~~
Phone\u..\-o....~ ~
Supervisor License Number ~~,~
\a\\o..S
Constr Contr. Number ~~~~
Expiration Date ~,,~~~~
r-
Ci ty ~....,<-~
Expiration Date
"
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OWners Signature:
-----------------~---~ - --,------
DATE: r- P ("'=')' Ii"J.Y':2... '
RECEIPT 'd (/1' ~'-'\ ~ ~
RECEIVED Ill: -') 1) .
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dwelling
Service or Feeder
B.
Services or Feed~rs
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
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5..
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL .
200 amps or less
201 amps to 400 amps
Signal'? of ~.pug ~::ician Over 401 to 600 amps
-~~ ~ Over 600 amps or 1000
C~ NameU~rr\ ~~:\~1\dlr(Ol~I~\Dranch Circuits
Address ~\f) (~~"'~~'\-l {)~ G ...ew, Alteration or Extension Per Panel
- d_ ..A.J'\\\ One Circuit I $ 35.00 . t.?..C-;
City <;: i. ~J\Q -' Phone 'C. -- \ \ Each Additional
. Circuit or with Service
OVNER I TALLATION or Feeder Permi t $ . 2.00 '
'$ 40.00
$ 55.00
$ 80.00
vol..ts see "B"
above
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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