HomeMy WebLinkAboutPermit Electrical 1991-5-21
SPfllNGFIELO ,
:ti! ~ ~L1 ~,'.F.!!J.iJ~ G 1./
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769'
OFFICE: ,726-3759
ELECTRICAL PERMIT APPLICATION
City Job Number q /1)( 9~
,
3.
COMPLETE FEE "SCHEDULE' BELOY
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
1.
LOCATION R~ETALLATION
b\330 ThlU'V 77f-
A.
LEGAL DESCRIPTION ".
17 n?., ~ 7_~ I 04 gO'Z)
JOB DESCRIPTION
~ k-. ',~. "l {'ji{ C G,',-t-
It ems Cost Sum
1500 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
,Each Manuf'd-Home or
Modular Dwelling
. Service or Feeder $ 35.00
Permits are non-transferable and expire
_if work, is nQt started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
B. Services or Feeders (10 Branch Circuits
included). Installation, Alterations
or Relocation:
. Address
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only'
/
City
Phone
Supervisor License Number
Expiration Date
$ 35.00
. $ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration Or Relocation
_,_ .....Expiration "Date._
-. .,200.ampsor-,less--
201,amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
--.----- -.-----..-----...-..-...._,...._._..____ .__.._,.._. _.._. . __ . _no . _..
Signature of Supervising Electrician
Ow~~r~ 'N~~e '~W.6it- '~~fl
I+si-er
D~- -Branch Circuits....
-- -.:--- $- 35.00 -.,...
$ 40.00 ,
$ 80.00
volts see"B" above
New, Alteration or Extension Per Panel
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 36.00
Sign/Outline Lighting $ 36.00
Signal Circuit or
limited energy panel $ 36.00
. _5. ----,SunTOTAL_.0F..ABOVE_u_~._______i3-~-..~--- ____on___.___.. ____
5% S ta te Surcharge { _ 717
u, "TOTAL'-' - ~-&'.;7b' un .....--..
Address 4 3fJ 6
City '5pf-1 J
Phone
97L{ 7>J
One Circuit
Two,to ten Circuits
Each Addt'l ten or
portion thereof
OVNER INSTALLATION
The installation is being, made on
property I, own which is not intended
for sale, lease or rent.
Owners Signature:
------------~--------------------------
---- -- '_._._n.._n_._ _'____m._.___<.}' _____ \mm._ __._ ___m. ___ _...,___.... ......un_..._..___ ""_..m..
,DATE: ...) 0-.\ \t') I , .
--n-.-_.RECEIPT-t:.... "h--:~.D":J~ -. .,..
RECEIVED BY: fJ~
$ 35.00 35-~
$ 50.00
$ 15.00