HomeMy WebLinkAboutPermit Electrical 1998-10-8
I
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
The toIloW1ngprotect 88 eubmIlIed ho8 the to ow
zoning, 'and dOee not requIn> apeclftc land u..
approval~-~ l-' ./
~m~ UVr ELECTRICAL PERMIT APPLICATION
9~i~~376r~~~:~J~~ 0rY' City Job Number r.-?tf}9~
3. COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF I~LATION
---I:J--Z---I J)~ ~---
-
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
!'7~~ Ifff:WoY/oD
reql!iles 'Iou to
JOB DESCRIPTION ATTENTION:Olegro-dIlW~/19h!:g~tltill'fts.s
1F.ptI1/4'~ g~~ l.:.~:'" '''.'es adoP\lE!~~\.a~re1,'<It'G'!AA~diOO
~' atiOncenter.T!lPpB{r ~A~~5~-OO1'
~ermits ~re non-transfer~bl~ an~ Ie 9152_001-001~lh!il~a~$~leSb~
1 f work IS no t started WI thIn 1BO ~ou rflay ob\5adIOlMlIFl& f?}/\\;' or
of issuance or if work is suspen 'tor the centelM\f&iJ1a~ ~n
1BO days. ca\ Ibn9r101tne Or~U\il!\'f 04, ked'er
, nUrfl e , . 800.::\32-234 "
C meflS \- ,
2. CONTRACTOR INSTALLATION ONLY e'B. Services or Feeders
Installation, Alterations
or Relocation:
Items
Cost
Sum
$B5.00
$ 15.00
,$ 40.00
200 amps or less $ 50,00
d 201 amps to 400 amps $ 60.00
Phone ~Wt./9~rd i\C#Ol amI's to. 600 amps...oDlL. $100.00
, ' NO 601 amgs ~~\fa\1\p&~un", $130.00
Supervisor License Number :? ~'7~ 5 1'\1\8 PEQv'erS\fOOO '-amps"I'~'?ttvf\~ IC, NOl $300.00
- Recoffi\eS[Rai1il~' $ 40.00
/ttJ-/-~/ AU1HO\'\!LI:U ,. BANDONEDf0n
.s''-II,it.Tempof'a9:~ ~ervices or Feeders
C Ins.tal1at1fOn, Alteration or Relocation
,,:.:,/ ~:Jl" ,h'
, 200 amps' 'or less L $ 40.00 4tJ.ci>
201 amps to 400 amps $ 55.00
SignatUfjMOf Su 'r~~si~lectrician Over 401 to 600 amps $ BO.OO
, ~' Over 600 amps or 1000 volts see "B" above
J i:o-, /l D. Branch Circui ts .'
Owner ame ' ':>t\ r/tJO/ (()~Critt>-- ,
..2 --r:;{, ('l r.J , r /'1 New, Al tera tlon or Extension Per Panel
Address n y /--1) I h \ () h OLl'-
r: . "l Ar /\0' One Circui t
Ci ty uuC1~ /10 _ phonejp,f I ~u:>UO Each Addi tional
o Circuit or with Service
OVNER INSTALLATION or Feeder Permit
Electrical Contractor _<;;IlL CJtI~
Address"B1JX 1~)5q
Ci ty {tUa-
Expiration Date
Constr Contr. Number~
Expiration Date ~-I'~-tl~
$ 35.00
$
2.00
Owners Signature:
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
The installation is being made on
property I own which is not intended
for sale, lease or rent.
DATE~------7()~gtf~~----------------
RECEIPT II: ~((J'1( )
RECEIVED BY: ' {. A_
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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