HomeMy WebLinkAboutPermit Electrical 1996-11-13 (2)
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726!:376,!<od S,gnQlu,o-1L111
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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ELECTRICAL PERMIT APPLICATION
City Job Number
_.
COMPLETE-FEE SCHEDULE BELOV
q (; I 41 q
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
LEGAL DESCRIPTION
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JOB DESCRIPTION
t\:W\ RE: 1i,,,..1:. (u..,,-~ 1.<: "F"'l~~ $PAUl
Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
/180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~ ~
Address
tvA
City
Phone
-
Supervisor License Number t.;023 5
Expiration Date
I ()-/ -qp,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number 10 A
Expiration Date
NA
Signature of Supervising Electrician
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Ovners Name~ill/>~ AI A..,g Rille-leEe-. D,-:r
AddressJ,fu u. '3h-rH STeet!T'
CitySPR'N4F/e:O, Phone 7Z/.,,-+,3/:'/)
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
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J_~_____________~______________________
DATE:J 1- I 3, - -I <:t
RECEIPT 11: U'o/'S78' I.
RECEIVED BY: n _ m ~1AtJ.tPff
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular .Dvelling
Service or Feeder
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
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D_ Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or.F.eder Permit \~
$ 35.00 3S,t)?
$ 2.00 38.Q?
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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