HomeMy WebLinkAboutPermit Electrical 1998-8-20
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~onii1g, and doeS not require specific Ian
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NOTIC~/onl""1 g' li ! ..
THIS ~~ 1l?rXu. EXi1!~9.IF THE WORllLECTRICAL PERMIT APPLICATION
d~ldmature;IY~~ .
9bb~~E~CeD~R 1~:~~~~N~~~~:O!i ty Job Number. 1f!6tjO
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ANY 180 D.~,y PEAIOD. 3. COMPLETE FEE SCHEDULEBELO'iJ
1. LOCATION OF INSTALLATION .
\ 3 \ 5 AS P €rJ ~ l. ' 'J
LEGAL DESCRIPTION 1163 Jf 34
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JOB DESCRIPTION
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225 FIFTH STREET,
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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
Address
City
Phone
Supervisor License Number \()73DS I
Expiration Date If) - Cf'iS
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
d (\.L~ Q '_'LV.
\~:!~IL(Name . S-,f R:"'<y+', """
Address \ xC] D Al.' t...(Q..,u.;2.
Ci ty. s:~ u'\u 'Y~ll,.-.(1) Phone f7q~ ~(-:J 3?5
OVNER INSTALLATION
The installation is being made on
property I own whi~h is not intended
for sale, lease or rent.
A.
()7Ao/
New"Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
1000sq.ft. or less
Each additional 500
sq. ft orpertion
thereof i;
Each Manuf'd Home, or
Modular Dwelling
Ser~ice Dr Feeder
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
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fe~
TOTAL
C. Temporary Services or Feeders
Installation, Alteration or Relocation
A~ftNilffi~:~9.Q!1;~W requires YO~i~~1 40.00
foKm, ro~dlopt~qbgy !~'Ppr~t f rtt:i5. 00
Nodl~~Q1ertter.6D@~f}!e5 are s _ 1~0 . 00
in c9A'Fr'95~tJ.(j)(}tOth.ro~gb~~ Sby "B" above
00 O. You may obtain copies of the ru es ,
D. ~~rftRg~he:MA*.t(t.Jote: .t~e tel~~ho~e .,;
3.'cJ"\O'b \..l:>\'~. ~mberfortheOregon Utility NotIfication
ew, .6~ntetffsl:~Oi~~2~~ion Per Panel
OneCirc~it I $ 35.00
Each Additional
Circuit or with Service
or Feeder fermit
Items
Cost
Sum
$ 85.00
$ 15.00
. $ 40.00 ,
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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