HomeMy WebLinkAboutPermit Electrical 1996-12-16
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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97477 cu,.".t.k.l~l~:V" ... ...,-".~... ELECTRICAL PERMIT APPLICATION
726-376~~:t:,c.ri:'..:::J '-:,.---0J~~ ... ...~~~~.__Job Number ~c.,....-~-:>
. 3. COMPLETE FEE SCHEDULE BELOY
Expiration Date ,1 -/-1
Constr Contr. Num~ /~\ 'Ie.
Expiration Date/ /19 _/- t/} 200 amps"oT less
~ ~. 201 amps to 400 amps
Signature 0 ervising Electrician Over 401 to 600 amps
~\ ~ _ C -~ _______ ~ O~r 60~amps or 1000
~. _~'l".,:>nch Circui ts
Owners Name #.4~,......r-~C~~~~ ').
p,' , . . New, Alteration or Extension Per Panel
AddressJ29~ '5 3..<~2' ~ ..
Ci ty _?~ -:7;>7:A!iBhone '77"0/ -~:~b
OVNER INSTALLATION
1. LpI.;..fjION OF .INSTALLl\~I~N'(')L
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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 ..J)lSTALLATION ONLY
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El~~al contractor~~M ~JI~cjr/L--
Address /2 Sw?~ .IT. / .
city/!l(7dr~( -\. 0) CflJ--;Z/}!
Supervisor License /tltJt:5
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
~rs Signature: .
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DATE: 12.. ~... ~ctG'. ~. -
RECEIPT #: -~~
RECEIVED BY~ ~~ _.
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
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
~$ 40.00
$ 55.00
$ 80.00
volts see "B"
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above
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One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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