HomeMy WebLinkAboutPermit Electrical 1998-1-28
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
ELECTRICAL PERMIT APPLICATION
cny Job Number
3. COMPLETE FEE SCHEDULE BELOV
776 c:; 74-
LOCATION QF ;rNSTALLATll,Qij.,.
<;(" .'S.--t1,,"-,.fVl "'~I~. . A. New Residential-Single or
. L-- j1i'8f.l;fFfA1; Multi-Family per dwelling
LEGAL Dl:;SCRIPTION A(~J~~ 71:~ ~~XE1aE ~~~~ Included:
IU ~ r -">-~ '~Ce RI:t~:l,!;!!~liI2IlmIS p ORK Items
I MENCED ERMIT IS NOT
. JOB DESCRIPTI.9~ AAV1BOO ORISABANDON€\9lt:r{Hl.ft. or less I
20 oT. _.~~ AYPER/0D Eachvallditional 500
. sq. ft or portion
thereof ~
Each Manuf'd Home. or
Modular'Dwelling
Service or Feeder
. . .'
," '. ""'o\"'ng project 99 submlltod has tho loll
'CiOn: and does not require speelfIc land use
'! . ..~al.
Zoning l tL V-
D.le I-L.\( -1~
974 Tf'uthortzed SIgnature n YV\
726-3769
1.
Permits are non-transferable and expire
if work is not started within 180 days
of' issuance or if wotk is suspended for
lBO days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~ ~~>
Address /111 cf:~ 4->'1 r!2 /1 .
City~..L Phone S'C;/&X'.f77/"2
Supervisor License Number <; ~7~ ~
Expiration Date /0 I j / - '7 55
(/; (/0 115
\..
tDd '1 i?
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
m/~__;.;(, A~,Y7_
Owners Name SI. 1/;.: (..;7 !J 7J D.
Address "'10.C:;: ~<:; C:::., ~
Ci ty Cl,~ Phone ~'f) 75'820
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~------/~:2-i:~~-----------------
RECEIPT'II: oJ'6~;,2""
RECEIVED 'BY: ~.u-
B. 'Ser~ices 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
unit.
Cost Sum
$ 85.00 8 S,c>-<"
$ 15.00 30. .-
$ 40.00
$ 50.00
$ 60.00
$lOO.OQ
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u volts
Branch Circuits
I
$ 40.00 ~
$ 55.00
$ 80.00
see "B" above
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E,
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
~.-
7} J','\ -
)f, IPs
~ /1(1.41)
40.00
40.00
20.00
36.00