HomeMy WebLinkAboutPermit Electrical 1995-10-27
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225' FIFTH STREET, ". epPI0V"~onjng-i/.L ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Do\e IJJiU /JA1 ./ /
INSPECTION REQUEST: 726-3769 :::JSlggnnaattuurEra "t".y J;i.'" 'r" Number -9........ , , '> .-,-::,
OFFICE: 726-3759 Aulhonz ...' /h ,./
3. COMPLETE FEE SCHEDULE BELOII q~(0f!3
1. LqCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
A. Nev Residential-Single or
Multi-Family per dvelling unit,
Service Included:
Items Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dvelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
Installation, Alterations
Electrical Contractor ~~An? ~~T~/r or Relocation:
Address 310"'2(" CE:rJ:f) "'- ':ils..' <:
City jOLt:-~1JI ttKc.. Phone 7ZhDt.,~1
Supervisor License Number 3Y"l"Z..s
Expiration Date 10/ { 1'17
ConsU Contr. Number 8"-/(.,,7'0
Expiration Date 7 J /4/ <f1>"
Signature of Supervlsing Electrician
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~' ~ D.
Ovners Name ~.A7J.<;~ / !)A-7iI,()e?J
Address
City Phone'
O\INER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
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RECEIPT jf:' ,L ~42 (,p ~
200 amps or less I
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
500~
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 100u
$ 40.00
$ 55.00
$ 80.00
volts see I'B" above
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service ~
or Feeder Permit ~ $ 2.00 IDO-
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
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5. /O~
. SUBTOTAL OF ABOVE ~
5% State Surcharge ~DO
.3% Administrative Fee ,i<~
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