HomeMy WebLinkAboutPermit Electrical 5-7-25
The following project as submitt<id h;;5; the 1;)!:
zoning, and does not require sp;x;ifiC land use
approval. ,
Zonina L PI?-
97477 Date//''l.-S "95
726-3A&t~orized Signature
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
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Ci ty Job Number tt9~ // ../.2
1.
3. COMPLETE FEE SCHEDULE BELO\l
LOCATION OF INSTALLA]10N
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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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.
2. CONTRACTOR INSTALLATION ONLY
Electrical Cont~actor ~/'~~~
Address
City
Phone
Supervisor License Number
Expiration Date
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dwelling
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
$ 40,00
$ 50.00
$ 60,00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name ~~ /' "q...e</~
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Address ~ ~'% ~ 57"'.
Ci ty ~~~.~Phone ~;>... ~~-< ='
o~ ' INSTAL~?~ . -
The installation is being made on
property I own which is not intended
tor sale, lease or rent.
~ers Signature:
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---------------------------------------
DATE:
RECEIPT, fi::
RECEIVED BY:
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200 amps' 'or less $ 40.00
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
,.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit I
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
~ $ 35.00 ~.~~'.
$
":<. . ~
2.00
not-included)
$ 40,00
$ 40,00
$ 20.00
$ 36.00
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