HomeMy WebLinkAboutPermit Electrical 7-2-6
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225 FIFTH STREET 6pproval. 'L 'D~ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477zonirY;J '" q 7DI 1-1 c..
INSPECTION REQUEST: n,,6-176J;,;1 Ci ty Job Number ,L"L - )
OFFICE: 726-3759 Dat~ /f} '1_ ~ r~ ^
l\LlthorllKl SIgnature , V /" \ 3 . rQHPUlTE FEE SCHEDULE BELOY'
1. LOCATION OF INSTALLATION
CJ..O 5 W. "(.\11 '51:,
LEGAL DESCRIPTION ,
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JOB DESCRIPTION
cS-er-v I ~ rJ1a.M8e.,;
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor ~5e L;,';.f2.
Address,/o/'9 7~ LJ'3:!/ Lr2A/e.
City Ea9t!V&/~ Phone hR~-oq(J5
, Supervisor Li2ens~ Number ~~~~
Expiration Date /tJ// /'qJ?
/ ,
Constr Contr. Number~~4f_~~
Expiration Date 9/.f?CJ /4P
~ /
Sign~rVi~~rician
Owner~ Name Joht\ k WllliJJ-
Address 5771 SP ~f)( _ St-
Ci ty Jltl"! walJ ~~ Be Phone
OWER INST~j1-;?J'L
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~---;[:G;=~~---------------------
RECEIPT #: LJlc;{v( ..
RECEIVED BY: !t-
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
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400. amps
401 amps to 600 amps
601 amps to 100d amps
Over 1000 amps/volts
Reconnect Only:~'
$ 50.00 5D~
$,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 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation ,
Sign/Outline Lighting
Limited EnergY/Res
Limited Energy/Comm'
not included)
$ 40.00
$ 40.00
$ 20:00
$ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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