HomeMy WebLinkAboutPermit Electrical 2001-3-5
225 FIFTH STREET . ~LECTRICAL PERIIIT APPLICA~ION
SPRINGFIELD, OREGON 9'prlh SiQl,a.\Il'. " '
INSPECTION REQUEST: 7~l>l31t~ City Job Number ()\.OO\~ .D\
OFFICE: 726-3759
1. LOCA'Q.ON..QF INSTALLAT1QN
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LEGAL DESCRIPTI~
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(\ .JOB DESCRIPTION .~
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Permits are non-&)ansfl)able and xpire'
if~ork is not started ~ithin 180 days
of 'issuance or if' ~ork is suspended for
180 days.
3. COMPLETE FEE SCHEDULE BELO\!
A. Ne~ Residential-Single or
Multi-Family per d~elling unit.
Service Included:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor Ge"""..d. clec:..\
Ha.u d o.,..j g po ed
Phone 7'11 -25'16-
365'4 S
/D -I-DI
Address c?QS"4
Ci ty _ Jt:, <fkl.
1
Supervisor License Number
Expiration Date
Constr Contr. Number g,14S
Expiration Date //-IO~D'
Signature of Supervising Electrician
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Ol.'ners Nam~\l N\. G.1'\ 1\.~
Address~R<6~ ~ ~ {\~ ~'\1"..&t
Ci tY~1\\.(\r\~ 0 lrlPhone.::l'llCl'~~
O\INER INSTALLATION
The installation is being made on
property I ol.'n I.'hich is not intended
for sale, lease or rent.
Ol.'ners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
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1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
ModularDI.'elling
Service or Feeder
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
It ems Cos t
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circui ts
$ 40.00
$ 55.00
$ 80.00
see "B" above
"
Nel.', Alteration or Extension Per Panel
One Circuit $ 35.00 ~
Each Additional
Ci rcu'i t or ~i th service, JL
or Feeder Permit $ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
40.00
40.00
20.00
36.00
$
$
$
$
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