HomeMy WebLinkAboutPermit Electrical 2001-5-25
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225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
ELECTRICAL PERMIT APPLICATION
City Job NumberAl,.. &~~~/
3. COMPLETE FEE SCHEDULE BELOY
1. LOCATJQN OF INSTALLATION If) '"11
~Ob -.{- ~.c:;I'\O()/I/\. /J':YU...OL q---( A. New Residential-Single or
o 0 Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
J "?~ /4:;l::? ~L).::4::?~ _
'~'JOB;~S~PTI6N~~~~~" 1000 sq.ft. or less
.. tJ1-5t 0 ~/l/IA.f! \V/~_iA. ~_ - ach additional.500
. r / q. ft or portIon
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
.-n ~' " Installation, Alterations
Electrical Contractor::-:1J-')/-l r:C'IJ2Jc )J712. or Relocation:
AddressA/ tJ!oS- 1./ ), / r.J!1 ~ I ~ 200 amps or less
~_ - c.. ,,! , ,', 201 amps to 400 amps
Ci ty'=.-UC elf,p., Phom(tS7, 57-7-0 401 amps to 600 amps
, - Go' '5' 601 amps to 1000 amps
Supervi~o-.: License Number, ') 61-/)/ ( Over 1000 amps/volts
Reconnect Only
Expiration Date 10 I, /01
. . I
Constr Contr. Number \':)~+S,><"'7-C
Expiration Date /fJ/' 11)1
Signature ,~/~iSing Electri~
11 O~
Owners N~e ~_ wntr; "- 0 D.
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Address "3Dc:' 1- ~ ~~
City~i.: QIJ Phone7'lro-?r-2 '?
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
~OO:~Jfh~~jle, lease or rent.
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01.. 'Ot; ~lG~jJ~ture:
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DATE:
RECEIPT #: -"'1
RECEIVED BY:./' ~ /~ _'
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$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit l
or Extension Per Panel ~
. \ $ 35.00 ~C);p-
$ '- J~
2.00 ~
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
New, Alteration
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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