HomeMy WebLinkAboutPermit Electrical 2000-7-19
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The 1o\lowio9 prolec\ at~enUjre speci1iC tan U
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225 FIFTH STREET Zoning - '7 _I Ii - cri
SPRINGFIELD, OREGON 97477 ~
INSPECTION REOUEs~ata 126-3769 ,a
OFFICE: 726-3759 lIuthOTizad Slgnatu -
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number()O -00 T I ~:-"O I
1. J.o\(AlJON OF JNSTALLATIOb
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LEGAL DESCRIFTION
1702.. l c,1.f 3. o9rbOO
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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
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
OIINER INSTALLATION
The installation is being made on
property I .ovn vhich is not intended
for sale, lease 0 nt.
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DATE: 0"7("(00
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RECEIVED BY: 'T"vZ
3. COMPLETE FEE SCHEDULE BELOV
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
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
. $ 4().00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 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
D.
Branch Circui ts
Ovners Name Gc:::r ,Lo.-r k:: I'V)
Address2040 PrO, fSn V-
Ci ty{bri/ctl/ 5 fJphone54;274[)-Lf~7o
$ 40.00 ifD
$ 55.00
$ 80.00
see "B" above
.'
Nev, 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 vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00 --<
$ 20.00 :D D
$ 36.00 iTiUi
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