HomeMy WebLinkAboutPermit Electrical 1997-1-28 (2)
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SPRI~GFIELD
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C '''~ :tll,:t.l-l. ./If/} I~CAL PERMIT APPLICATION
97477 ,\ulhQrizOO Signalure A /L-+t1 ~ >- 0""-'7 ':2.
726-3769 I City Job Number ~ " (. )
3. COMPLETE FEE SCHEDULE BELOV
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REOUEST:
OFFICE: 726-3759
1. LOCATION OF,-l;!'STALLl\TION
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LEGAL DESCRIPTION
ISO? 00/2.(i:JtbtJv
.,TOB DES~PTION
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Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor \'
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name~~ ~~ &;d
Address '7>q q 7)n :<))\I1&(-S+-
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City 1 Phone 7tfLI.;ffJ~(?
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OVNER I S LLATION
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items 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 'Dvelling
Service or Feeder $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
^ $ 40.00 t..fo()[)
$ 55.00
$ 80.00
see "Btt above
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Nev, Alteration or Extension Per Panel
$ 35.00
$ 2.00
not included)
E. Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
C Owners ~e~ ---= Limi ted Energy/Res
~_~('" Limited Energy/Comm
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DA~E~--7~~-~=cr~-------------------- . 5~~~;~; ~~r~~~~~e
RECEIPT 1I:_:I~L//1 3% Administrative Fee
RECEIVED BY: Ci::: TOTAL
.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
C.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
$
$
$
$
't{O. rJD
:2. /T?)
/..m
L(:{ :JJ)
40.00
40.00
20.00
36.00