HomeMy WebLinkAboutPermit Electrical 1996-5-1
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914;' Z;l L~f} ~J), ELECTRICAL PERMIT APPLICATION
7~h6t'1~ 9 1ure ~'T'-city Job Number 9& Or) / ()
3. COMPLETE FEE SCHEDULE BELOY
225 FIFTH STREET
SPRINGFIELD,OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. .LOCATION, OF INSTALLATION
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LEGAL DES~PTION
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J!JB DESCRIPTION/; i \1 ,,'
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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 INSTALLATION ONLY
Electrical Contractor__~~ ~e~.~
Address (f- () 60 K " 4 q '? '\ .
Ci ty ~ "'J P..__ Phone ~fb -l.. ). 3("
. Supervisor License Number ~ c; q J 5
Expiration Date / D -1- q,y
Constr Contr. Number /oa>cf4
Expiration Date / J. -J-') - 'r C,
Signature of Supervising Electrician
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Owners Name AlA-V f" /lJA A/r.-M ~~'
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Address 1:7 Jlo rJ~/P{:;'Il./
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. Ci ty YI'l.AvJf; y~Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
D~T~~---~:{~-~-~-----------------------
RECEIPT #: 2;3'1 ~
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
Ser~ice or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less l
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
<;()OV
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Branch Circuits
,.
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit 6
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
,/2uV
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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