HomeMy WebLinkAboutPermit Electrical 1995-5-30
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225 FIFTH STREET .. . Zonin . L'Dt2- ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 r:J__~_ n e^/ fl~.
INSPECTION REQUEST: 726LJ.~~_~-<iS City Job Number '-1 ~ll J
OFFICE: 726-3759 IwtJl0lii:~~ifJnature i If\^.
~.\ . ~T:ri' ,.P..EE SCHEDULE BELOV
.1. ~~F~~~~\t1 .
. LEGAL . DESCRIPTION 8. .
of Supervising Electrician
coo
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Owners Name _~~ ,U
Address ( o10t 1d-
Ci ty 1JLo llw Diy Phon~~ 7
~
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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RECEI!'! #: 2~?~~ - '\ <1.. ~
RECEIVED BY: ~~'lr--) ~..L
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A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
,~...,.-
Branch Circuits
Items
Cost
Sum
---t . ,JO'>>pCRIPT~ON 1 1000 sq. ft. or less
\JlX'f\ . \J ~ Q j~ Each addi tional 500
sq. ft or portion
Permits are non-transferable and expire thereof
if wor~ 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
2. CONTRACTOR INST~LATION ONLY / B. Services or Feeders
Installation, Alterations
Ele~ Contractor or Relocation:
Address. ~ ' ~ 200 amps or less $ 50.00
~ / 201 amps to 400 amps $ 60 00
City ......~ Phone 401 amps to 600 amps $100:00
~, ~ 601 amps to 1000 amps $130.00
Supervisor License/umb~r" Over 1000 amps/volts $300.00
~ Reconnect OnIy $ 40.00
Expiration Date -~
~. Temporary Services or Feeders
Installation, Alteration or Relocation
- 00 amps' lOT less '$ 40.00 4f2
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
$ 85.00
$ 15.00
$ 40.00
,"
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or wfth Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
":'f ....'... ....
....):.:::...:
$ 35.00
$ 2.00
not included)
$
$
$
$ 36.00
~
. (.lJIJ
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40.00
40.00
20.00