HomeMy WebLinkAboutPermit Electrical 1996-12-16
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225 FIFTH STREET :.~~;~;,:r"d doc,' no:r.qp'll'.^=:,'C I," Ii,') . ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9747?~"i'G
INSPECTION REQUEST:r ,726-3769 ~; :-.... --:-.--
OFFICE: 726-3759 . -"I". 1ft
1. LOCATION OF IN~~A'rU;~~6~.1.,,-'--Iz--IILl JCjtp COMPLETE FEE SCHEDULE BELOII
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.'1. _ LEGAL DESCRIPTIOt!p 3600
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JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days.
26NTRACT~LATION ONLY
E1e~ei' contract~' t'",
Address /;1.. _ \ I,,) rei
Ci ty /JIII/IV'I! <"
, .
Supervisor License
Expiration Date ~
City Job Number
Ney Residential-Single or
Multi-Family per dyelling
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dyelling
Service or Feeder
~. 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
~S25ko ~
uni t.
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
200 amps"or less -$-
201 amps to 400 amps
~ ~gn(~~ Supervising Elec rician Over 401 to 600 amps
Over 600 amps or 1000 volts
- ~ ' .:.... ""-~ r ? - .. , --=-- .
~~nch Circuits
Oyners Name ~.".-z:e-,A/ C/!f~ ~
Ney, Alteration or Extension Per Panel
Address 1!i?"'3~ -S~ '72#2>
City ~ Phone?Vq~~
E. Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
~.:~~~. ature: Limited Energy/Res
~ () ~ ~ ~ited Energy/Comm
~ '-..::-----...
----- ~ . SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
Constr Contr. Num er
Expiration Date
/tJ -/-
OIlNER INSTALLATION
The installation is being made on
property I oYn Yhich is not intended
for sale, lease or rent.
DATE: / '2 -;4:'-,%
RECEIPT #: 2~~
RECEIVED BY: ./,.~.
One Circuit
Each Additional
Circuit or yith Service
or Feeder Permit
$ 40.00
$ 55.00
$ 80.00
see liB"
y.t:7
above
$ 35.00
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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