HomeMy WebLinkAboutPermit Electrical 1997-10-24
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SP.IELD II ,," I
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Authorized Slg~~ 'n M (I:V~()~~"'4~
225 FIFTH STlili)rr--l-l- '-;~ ""IY~ /.sJ ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 4%. ~~~ ~O ~/,
INSPECTION REQUEST: 726-3769'6'0 V~O V"'a '<~-b City Job Number Cll () 11"s-
OFFICE: 726-3759 04;- 0", ~"'~~<?~
1. LOCATION OF INSTALLATION ;O~~;.s'46'~ r{s>;o~ Jt;E FEE SCHEDULE BELO\I
61lli ~d.e>,l (l h~ ~ . ~OQ~i!I}e~Ential-Single or
U tl~~m~y per dwelling unit.
LEGAL Dpql,IPTION '"'\ J Se .~;rG,pnc1uded:
110,.,10'i'Y'OI,~O,;-- Items Cost Sum
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.
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2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor(\'JXAVI F:lorly-LL.
Address ~::, I sl 0 (D I!Vln tb 'J!\...>
Citl ((7?urdQ Phone 9,c6, 2}-{UO
Supervisor License Number ~ICI-<)
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Constr Contr. Number lQ(g'l\C(L\
Expiration Date 1{1f11S
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Expiration Date
~e~~iSing Electrician
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owne~a;eV (;..v(\E {0'd..J..R.L
Address .3 7 L.f ~u.-.. "
Ci ty ~ Phone -.7!f:..t., -57.:K1
O\INER INSTALLATION
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations
or Relocation:
$ 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
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 55.00
$ 80.00
see "B" above
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New, Alteration or Extension Per Panel
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One Circuit
Each Additional
Circuit or with Service
or Feeder Permit ~ $
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 35.00
2.00
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E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or ir.rigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
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DATE: 10 -,J-LJ-91
RECEIPT #: .:;1..-, K+""j
RECEIVED BY: ~'.A.
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