HomeMy WebLinkAboutPermit Electrical 2001-5-30
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225 FIFTH STREET .
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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1. , LO~TION oh INST,~LA.T!QN
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LEGAL DESCRIPTION
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JO~. ~ DESCRIPTION~O~I\ '
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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.
ELECTRICAL PERMIT ,APPLICATION
Ci ty Job Number () L:j)..J)C) If .~: -() I
~ _.--;:;:::7 r--
3. COMPLETE FEE SCHEDULE BELO\{
A. New Residential-Single or
Multi-Family per dwelling 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 Dwelling
Service or Feeder .$ 40.00
2. CONTRACTOR INSTALLATION ONLY ,B'. Services or Feeders
Electrical cont.ractor/v..... },S [/eu/r,'vk, Installation, Alterations
.or Relocation:
Address PO& y Ilj<6~' .": 200 amps or less $ 50.00
, 201 400 amps S 60.00
' ; SoP/d. 71J/-Jd30 amps to
City Phone 401 amps to 600 amps $100.00
, I I&~/S 601 amps to 1000 amps $130.00
",
Supervisor License Number Over 1000 amps/volts $300.00
/0-1-01 Reconnect Only $ 40.00 ',..
Expiration Date
.' Cons.tr Contr. Number 'dO /LJC
,Expiration Date, I () - / - OJ
S\r[~Electridan
'lers Name~ S1A Y3 . ,.
Address '90 " 0U30 ()
Ci ty. . ~-rfl ' Phone/L(0~ ~50
OVNER ~N~TALLATION
The installation is beirig made on '
property I own whi~h is not intended
for sale, lease or rent.
Ovners Signa ture: ,
-..,
O"52-yo(
5''55/
']\t'(
DATE:
RECEIPT tf::
RECEIVED BY: ,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00 Lto
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
,
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or with service~ $ t
or Feeder Permit 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
5.
$ 40.00
$ 40.00
-'" -::::I
$ 20.0035~
$ 36'~rrL~
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....: 10. ... m."-;' I-l.
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~I~ c;{ ~~6 25
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Ci'" rTl co 0 (J1
f--L .. 0 f--L --:J
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL