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HomeMy WebLinkAboutPermit Electrical 1997-3-6 (2) @ I h,.. r' . ~~~. ,c,.')Wm2- rr"'jf")ct c.c ....,.... ~ L n"ilJ, I.V1d dV.,;.J n.:.t n. 'J: 'il. . arpr:>val. ~-.... ~.'_ DeB ZY~:r~DL 225 FIFTH STREET .. ~"f--:,-/. ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 AU:horiZadSjgnaturo~ a r I ~(11 INSPECTION REQUEST: 726-3769' ~ei,t-y",J.o,b.. Number \. 10 ~ OFFICE: 726-3759 . 1. LOCATION ~INS!ALLATION \~O'3. tr.r,,\.~ '" LEGAL DESCRIPTION \Iiil. \. 1 ~ '3. ~"1 ~ \(') \. ~UJ ~Jt. ~&J!I~Lt/~ SeAC4;;' erml ts a~~~ and expire . if ~ork is not started within 180 days of issuance or if work -is suspended for 180 days. \ CONTRACTOR INSTALLATION O~ Electrical Contractor ~ . Addr~" . / City ~ /Phone ..... n~Number ate ~ ~ ~ Supervisor ... Signature of Supervising Electrician Owners Name ~ .....,.\.J ~ /~~ "- Address U~,..D3 r ~ oJ.':.." ~ Ci ty _ '\:\'. Phone" q I..;.,'=> ~ 7~ OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. -:miJ~j~"j" · p, Jl1k- DA~~~-~~-(;:--~------------- 1U>LMl'T I: n.J 4 ""7/) ?t-- RECEIVED BY: /1. /YltZ {h:J-d.6 3. COMPLETE FEE SCHEDULE BELOY A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular 'Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 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 $ 50.00 /S"tJ,o"D $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 100v volts $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits o' New, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or with Service or. Feeder Permit i!fIO $ 2.00 -'I tf a:J E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation .$ 40.00 Sign/Outline Lighting $ 40.00 Limi ted Energy/Res $ 20:00 Limited Energy/Comm $ 36.00 SUBTOTAL OF ABOVE / q () _ <16 5% State Surcharge q .,50 3% Administrative Fee S. '7 U 'J! cOnS. 20' 5. TOTAl.