HomeMy WebLinkAboutPermit Electrical 1997-3-11
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
Di$.tt;]--- l\ ""-'11
97477 I~" t
1'72Y/27376~gna ure
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPj:.ION
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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 Rrrlnt>t 'Shu.e
AddressPtll1 Jl{lllt, l1rarlow Lt.h.v
,\,.;
Ci ty 5pd,~ftdd ' Phone 7l.J6-lJ..{:i)
OVNER INSTALLATION
The installation is b12ing made on
property I own which i~ not intended
for sale,' lease 9r rent.
._ Owners SignajL. .. . . . .
-~~~------~~------~~-~~---~----
DATE: ~-//-.??
RECEIPT #: ~ y~~
RECEIVED BY: ~..,
...
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ELECTRICAL PERMIT APPLICATION
d ty Job Number:- q /~3~O
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3. COMPLETE FEE SCHEDULE BELO~
A. New Residential-Single or
Hul t i-Family per dwelling uni t.
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 $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
D.
Branch Circuits
,.
New, Alteration, or Extension Per Panel
One Circuit I
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00 ~
--
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigati~n
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$
$
$
$
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/. e> 3"""-
'77. t5d:>
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5%'State Surcharge
3% Administrative Fee
TOTAL