HomeMy WebLinkAboutPermit Electrical 2004-6-2
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225 FIFTH STREET. SI'RINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726.3689 0\&S61l\)\106\1
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3, COMPLETE FEE SCHEDULE S' V
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A. New Residcntial- Single 8"~1\'lulti.Falllily per dv.,elling unit.
ELECTRICAL PERMIT APPLICATION
City Job NumberC-Ol+t'Z='-\ - oo6Ll7 Date
I, LOCATION OF'INSTALLAnON
7 1.'" i2., vCi- )./ 1I..l. S j)~ .
LEGAL DESCRIPTION
iiO-:>"3l1l2.
("3,000
JOB DESCRIPTION
?U N goOlM.
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
CONTRACTOR INSTALLATION ONLY
2, Wl't~ eL.~ u..c.. cQloo..
Electrical Contractor P.4<-l fi c.. ~ I...~.
Address Po g > Df3q I
,
City t;.u6, 1;,..) t.
Phone 'fP,'i - 5"'Z.OD
Supervisor License Number f~;'.:51i S
Expiration Dale I~/(J / / {)cf .
Constr. Contr. Number 1 S-z. 7 b to
Expiration Date c,/ ~/ 0 I.(
, ,
Sign;:g:rv~C7J
/' ~ --
Owners Name ~A ~d(c.c.
;2", b<I- ~ lis ),(L
Address 721./
City S?,C1
Phone
OWNER INSTALLATION
TIle installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Service Included
1000 sq. ft. or less
Each additional 500 sq, ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ )9,00
$50.00
B. Services or Feeders - Installation, Alterations or Relocation:
200 Amps or less $ 63.00
20 I Amps to 400 Amps $ 75.00
40 I Amps to 600 Amps $ ) 25 .00
601 Amps to )000 Amps $)63.00
Over 1000 AmpsNolts $375.00
RecollIJl\~I.mON: Oregon law VGgUlfGOSl}9:UtfllJ
follow rules adopted by the Or0gon Utllltl1
(;, TeflWllO@;I'M.iliM{lgntor.Fflldl9S rules arQ sat fortib
in OAR 952-001-0010 through OAR 952-001-
Instal8!1!.<m, '1\l!.l'mayIOOtllUllq(l!t141l of the rules blf
200 AmjillF.&~@.he center. (Note: the tel~~&.ee
201 AnJj'l\l:ftllal.lofA~ Oregon Utlllt'f NOti$i~t!RfD
401 Amps to 60~~~ is 1.800~"".",)'K''$100.00
Over 600 Amps or 1000 Volts see "B" above,
D, Branch Circuits
New Alteration or Extension Per .Panell
One Circuit I $ 43.00
Each Additional Circuit or with ,
Service or Feeder Penn it $ 3.00
'i"',
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E, M~m~W~rJffs~~[tt*P\~~I'f'm~)weMK Installation
PumptdJlTM&RibH:D UNDER THIS PERMI'\;; ~~pT
Signl<Qqjli.D~\bllii't[jJg OR IS ABANuUI~r:D rg~oo
Limite'd'El,ct-~IOO)\J\@IOD, $ 25.00
Limited EnergylCommercial $ 45.00
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
4, SUBTOTAL OF ABOVE
~b
"}.~z...
Lf . Idu
s3.Bz..
7% Stale Surcharge
10% Administrative Fee
TOTAL
Shared Drivc(T:VBuilding FonnsfEh.'Clrical Permit Applicntion 1-03.doc