HomeMy WebLinkAboutPermit Electrical 2002-7-11
225 FIFrH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQ~ST: 726-3~69
OFFICE: 726-3759
.
EL&CAL PER!\.1IT APPLICATION
City Job Number (!) 2-00 7{gCl-O!
3. COMPLETE FEE SCHEDULE BELOW
,
I. LOCATION OF INSTALLATION '
~(a 2 '~Yh- R:,.,;J?/-/ /;;).4:-/ A. New Res,1\101ti:~]-Single or -. "
1 \,<:-elO")lilulti-Famil)' per dwelling unit.
LEGAL DESCRIPTION ./1 o,<:-"'s 0 \",('00 Service Included:
} 7 n '? 2J-4.1 / / ~t/1J s'<I"''''\'':geo\\\ Items Cost Sum
. \~':l r\~\~e n /
'eO le~ );)\~.
JOB DESCRIPTION 0 \('o'lJ9:\ ('00\ I.' 10 sq ft. less $106.00
T~L? ~U'~o\~~ ~ , 0 ":: \ acb Itional500
1.of\\~'\I'3-\' (\\(\~ " \ \ ~. ft or portion
Permits arc non-transferable i6m''expir&o ' I thereof $ 19.00
if work is not staned within 180 days ",\'<1,'0 Each Manufd Home or
of issuancc or if work is suspend~~r eo'iJ\'lJ('o Modular Dweliing
180 days, p..'<I\,<:-ol\'!; Service or Feeder $ 50.00
2. CONTRACTOR INSTALLATION ONLY
B. Sen';ee.' or Feeders
Installation, Alterations or
Relocation:
Electrical' Contractor
Address
/
200 amps or less
20 I amps to 400 amps
401 amps to 600 amps
I
601 amps to 1000 amps
O\'er 1000 amps/volts
Reconne'ct Only
~$63:00
$ 75.00
$125.00
$163.00
$375.00
$ 50,00
Cit)'
Phone
Supervisor License Number
, '
Expiration Date
i
C. Temporary Serriees or Feeders
Installation, Alteration or Relocation
'. Constr Contr, Number
Expiration Date r__..
200 amps or less
201 amps to 400 amps
-, -._Ov"r 401 to 600 amps
Over 600 amps or 1 000 volts see
"Bll aboye ."
v- $50.00 ~,(kJ
$69,00
$100,00
Signature of ~uJlcn'ising Electrician
Owners Name '5'7Ar.J r~Tkn
Address <5'<lO U"~Q'~4,
City LU.:; Phone .11 S -7 'fJ 7
OWNER INSTALLATION
The instaliation is being made on
propeny I o\m which is not intended
for sale, lease or rent.
D. Branch Circuits
New'Alteration or Extension Per Panel
One Circuit
$43,00
Each Additional Circuit or with Service
or Feeder Permit
$ 3.00
vo.~v?eI'S Signat~re:
_~h\ ~
..... , -
E. Miscellaneous (Seniee/feedel' not included)
-Each installation
Pump .or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited Energy/Comm
~ $50,00
$50,00
$25.00
$45.00
l\linimum Electric Permit Inspection Fee is 545.00 + Surcharges
TOTAL
c;-E> ,"'"
j,;::
,
5"'75'0.
,l(M~~ 1/If/P:z.
57,50
~/~fl\C
~ 9t?p?
4. SUBTOTAL OF ABOVE
70/0 State Surcharge
8% Administl'atiye Fee