HomeMy WebLinkAboutPermit Electrical 1995-6-9 (2)
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Authorized Slgnatur. N IV\
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
D('J~~"; K4l>lc.H -71)5 'J"y,~~IS ST.
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JOB DESCRIPTION ,
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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 'i023 S
Expiration Date 1(')-1- 95
Cons t r Con t r. Number ^" /./1.
Expiration Date
~" 1./1.
Signature of Supervising Electrician
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Owners Namelll;UA~/A..,J>; f'AR/::.t&-.
Address t$M l~. -:u.~.
Ci tYSf>RI~~I€t/,
Phone 77...::-.,....~'"
OYNER INSTALLATION
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The installation is being made on
property I own which is not intended
for sale, lease or rent.
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Owners Signature:
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~ATE;----G1Ttl-rt?~-------------------
RECEIPT #: ~Id'[l[ 1- L-
RECEIVED BY: l , rr
ELECTRICAL PERKIT APPLICATION
456lfQ~
City Job Number
Gorrl'tETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling uni t.
Service Included:
It ems 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 or less I
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00 ~t),;?~
$ 55.00
$ 80.00
see liB" above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder.Permit ~
$ 35.00
$ 2.00 L.{,C;O
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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