HomeMy WebLinkAboutPermit Electrical 1995-11-21
The following project as submitted n.."\!l the (ollo~
zoning, and does not roc;!.!ire cpecinc land use
approlJe!.
Zonin" +1 \
225 FIFTH STREET O,fe \ 1_ ~\ _qS ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ,
INSPECTION REQUEST: 726.JllMlS1lzed SIgnature 0..., 0 I'i.:'_Job Number '75" /7.9/
OFFICE: 726-3759 \
3. COMP~TE FEE SCHEDULE BELOY
1. LOCATION OF :jJlSTALLATION
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LEGAL DESCRIPTI9N
J 76? 2 .;y') ~.,. O~ ft:C)'rJ
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
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name ~/?St J .~~)'6'
Address -:( ~2...5- ~&..#LJ?..e?/(,
r' ,
CitY~/"-?il:r/~ Phone.?d7-"~7t3
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
OAT
RECE PT 11:
RECEIVED BY:
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A. New Residential-Single or
Multi-Family per dwelling uni to
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 '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
~--
.p- -S 50.00 _ .
--$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less ..-- $ 40.00 ~6u
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see IlB'~' allove
Branch Circuits .
D.
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
E.
5. .
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$
$
$
$
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( "7 t!N:1
'/.~
..d.i :LGL
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40.00
40.00
20.00
36.00