HomeMy WebLinkAboutPermit Electrical 2998-3-12
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Datr3-I?_~ ELECTRICAL PERMIT APPLICATION
97 4 7~uthorized S;gnature~ /'./ ~, D'" PlI
726-3769 ~itt-Job Number ~~, L-C/
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225 FIFTH STREET
, ,SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOC4TION OF. ~STALLATION
, /7-:2- 5" ./f51y~ Oi ) ..(~ ~~?
LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuanc~ or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
/
Phone ,/
License Numb~
Date / .
City
Supervisor
Expiration
Constr Contr.
Signature of Supervising Electrician
Owners Name ./P~ U/~
Address, /f2S"'*Jc"vh ~ I
City ~J Phone-$'-~71/
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
j........f?L-!JIl../'J/ L' bJ/JAA/Ar )
--------~------------/C----------------
DATE:- g ;/2/ 5'~
RECEI PT it: I ":217 t9 "}ik
RECEI~D BY:, /~ 4~
3_" COMPLETE FEE SCHEDULE BELOY
New Residentia17Single or
Multi-Family per dwelling unit.
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
v-- $ 50.00
L-- $ 60.00
$100.00
$130.00
$300.00
$ 40.00
~~ba
~~
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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 100Q volts see "B" above
D_
Branch Circuits
New, ,Alteration or Extension Per Panel
,.
One Circuit $ 35.00
Each Additional
Circui t or wi th Service J
or Feeder Permit 12- $ 2.00 2-~loO
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Eriergy!rComm
E.
5. ,SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$ 36.00
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