HomeMy WebLinkAboutPermit Electrical 1997-10-16
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225 FIFTH STREET Authorized Signature h ('A '';''9.'" ~ It\,P ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 974Tk\('~' ~~\>.:~,~\'O \l'i;: "-0 ~O'?- . /
INSPECTION REQUEST: ~GllV6~~\\ '2) 'i)"''?- \" ~\OO~'v City Job Number Cflo l/p g l.t>
OFFICE: 726-3759 5\l'i;: O~~ ~~~'
~y.~ v..O~te O'?- \'0 3. COMPLETE FEE SCHEDULE BELOII
1., LOCATION qF IN~ALLAi ~~C",O ",,?-\OO.
\ \ \ \ ~~ ~ .t'''~ \l . A. New Residential-Single or
n~-.II\l)\jo,?l)O;2. Multi-Family per dwelling unit.
LEGAL DESCRII(TI.Qr:l - - ~"'1;'..-I Service Included:
O:::Y\te-V\V\~oJ ~eJ( i:1ro..~e..-. Items Cost Sum
JOB DESCRIPT;rON1 1000 sq. f t. or less $ 85.00
Act:~s.~ c..orrf-ro Each addi tional 500
sq. ft or portion
Permits are non-transferable and expire thereof $ 15,00
if work is not started within 180 days Each Manuf'd Home. or
of issuance or if work is suspended for Modular 'Dwelling
180 days. Service or Feeder $ 4.0.00
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor Mess COT\-tfcl th\td
Address Ii ~ ) I~ 1 W\ "'\r\ sJ..-., G
City c;;,~ Phone 74 ( - ;:2..LJ.l13
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Supervisor License Number
Expiration Date
Constr Contr. Number
Expira t ion Da te
Signature of supervis~ Electrician
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The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: I b -1(" -q7
RECEIPT #: ::J./I (J;O
RECEIVED BY: k.uJ
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
$ 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
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see liB" above
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
\le.\I\ $~\ D. Branch Circuits
Owners Name .
IbL\'D '\ ~\ ~ 'f\ New, Alteration or Extension Per Panel
Address
One Circuit $ 35.00
Ci ty t.~C"V\ <2 PhoneJ,.RR-14.0Q Each Additional
Circuit or with Service
OIlNER INSTALLATION or Feeder Permit $ 2.00
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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