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HomeMy WebLinkAboutPermit Electrical 2005-5-23 \fJ~~cP tb~'Y1 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PRRMIT APPLICATION City Job Number ~~~ _ Date I. LOCA710N OF INSTALlATION ~q'?-{?J i1 POful~ L1~{)IraP~I\\ (A~CD JOB DESCRIPTION I _.. O_ r '"1(\]\ (\\j to:rcuY\ Permits are non-tra fcrable and expire if work is not started within J 80 days of issuance or if work is Suspended for 180 days. CONl"RACTOR INSTALLATION ONLY Address City Expiration Date Signa re of Supervising Electrician OwnersNa~ r&rlt ~ODL~ A""~~~" 1~~ City hone 141'1.~go OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. '7j):tS~:~~~ o ~Ja4LC( p Inspection Request: 726-3769 3. COMPLETE FEE SCHEDULE BELOW A. New Residential- Single or Multi-I;'amily per dwelling unit. Service Included $106.00 $ 19.00 $50.00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. Temporary Services or Feeders N (jilS~@)~!ion, Alteration or Relocation THifiofAifi'p'51l>Tla+.iALL EXPIRE IF Tj.j~ \^'f)f~Ro.oo A~I[gfqiIiI@ 19IQ~~sTHIS PER~!IT '€ '!(j169.00 Cow.lvlf'i\ii}~'2l6BQI"i~PABANDON:~ F811 $100.00 AfI\'i)vtMo6JAlh~IDtU(l)QP. Volts see "B" above. D. Branch Circuits New Alteration or E,xtension Per Panq One Circuit \ Each Additional Circuit or with - \ Service or Feeder Permit $43.00 ~ $ 3.00 ~. E. Miscellaneous (Ser\'ice/feeder not included) -Each Installation Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges IV) 4. SUBTOTAL OF ABOVE 4.~ ~ ;, :" I1__ 7% State Surcharge "1: L.t... ~::::ministrative Fee 'f:}~ViIi Shared Drivc(T:)/Building FonnslElcctrical Pennit Application l.a3.doc