HomeMy WebLinkAboutPermit Electrical 2001-10-15
225 FIFTH STREET
SPRlNGFIELD, OREGON97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
ELEl..1RICAL PERMIT APPLICATION
City Job NumlJer (!!!/ C) 1/ .J?o/T~~~~O::
lJn"!L~
Ai-iT REeD ~:2 ~v .~
3; CO~LETEFEESCHEDULEBELOyV
1. ~, OCATION OF INSTALLATION
cJ3d.f.o ~_ 54.
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
I -103 :). s <-f3 0 S,?;,UU
Items Cost Sum
JOB DESCRJPTION 1000 sqJt. or less
.c~c< V T C f C- h V\f\Lc\. t:: Each additional ~OO
J HI'" toliowlng project as submi~ffdjjaS thlJ,!PilowIn9
, i(,111i19 and does not require $pe'CifilJ RiWdJ8Ye
Permits are non-transferable and eXRb)5toval thereof
if work is not started within 180 days z' ~ Each ManuI'd Home or
, _', . onlng .
of Issuance or If work IS suspended for 'Z..- -1 $"' _ 0 I ~odular DwellIng
180 days, ';em- 'serVlCe or reeaer
-K..v...)
$106,00
$ 19,00
$ 50,00
,dlfl'AlzeC Signature
2, CONTRACTOR INSTALLATION ONLY B. Senrices or Feeders
Installation, Alterations or
Relocation:
~
City "~~hO /
- (
Supe""sor Li~) rbe"'-
EXPirat~Dt, ~
cont)~ Number
, E~tion Date
Electrical' Contractor
(Y) A-\'2...lL G:;r Lm J\1~
a to '3. 5-\
200 amps or less
20 I amps to 400 amps
40 I amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 63,00
$ 75,00
$125.00
$163.00
$375.00
$ , 50,00
Address
Signature of Supervising Electrician
amps or
201 amps to 400 a
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"B" above
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit
City C;pr \ I\.\ ~ rl (l,i Phone (sli I')
OWNER INSTALLATION
The installation is being made on
property I o\.vn which is not intended
for sale, lease or rent.
1 '17- '?)C(;7/
Each Additional Circuit or with Service
or Feeder Permit $ 3,00
owne:~~na7tucc'~~:I' l '~"
/1/ r#l [y,'I-?---?-
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump'or irrigation $50,00
Sign/Outline Lighting $50,00
Limited Ellergy/Res $25,00
Limited Energy/Comm $45,00
, ~~
Minimum Electdc Permit Inspection Fee ~ $45.00 j:.$urcharges
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
LiS-
TOTAL
7)
.S-I -