HomeMy WebLinkAboutPermit Electrical 1995-8-7
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225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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974 7()elo g -,- <1..(
726-376Y N~
Authorized Signature
ELECTRICAL PERMIT APPLICATION
City Job Number~//~Y
1.
LOCATION OF INSTALLATION
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical contracto~ AUI\Ul.; ~v
Address ~.n. P.oJG ~ ' .
Ci tyJt... 01& 't1#f Phone C(1r -~4-:r
Supervisor License Number ~~~
Expiration Date IO~s
Constr Contr. Number ro - 1<6::'0
.--
3. COMPLETE FEE SCHEDULE BELOII
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Sum
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular, 'Dvelling
Service or Feeder
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
$ 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
Expiration Date
'1-:~~" ".<".<;..
Ovners ;tme ~~-o/r~~'",""'1Y~
Address ?~. ~ ~ V:=:
Ci ty ~~~. Phone ?"Y"/'''/~?
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O\INER INST~LATION
The installation is being made on
property I ovn vhich is not intended
for sale. lease or rent.
Ovners Signature:
---------------------------------------
DATE:
RECEIPT 11:
RECEIVED BY:
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200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
$ 40.00 lJD.~
$ 55.00
$ 80.00
see "B" above
"
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permi t
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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