HomeMy WebLinkAboutPermit Electrical 1993-4-22
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225 FIFTH STREET ~- ,<;,.. ~\ V ELECl'RICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 )"\O~<>. ". Il) ~. ~
INSPEcrION ~OUEST: 726:3769 'Z,.o'.\v"-\-I ~ City Job Number qZ):?tPe>
OFFICE: 726-3759 k. .,"""" '
0<>\0"'----. .j'" - - - 3. COMPLETE FEE SCHEDULE BELOI/
1. LOCATION OF INSTALLATIOl!u\'(\O\\c.'-
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LEGAL DESCRIPTION
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J~SCRIPTION
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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 ~..........-~~ ~
,c:.. -"- ::; J
Address
City
Phone
Supervisor License Number
Expiration Date
"
SPRINCFIELD
A.
New Residential-Single or
Multi-Family per-dwelling
Service Included:
uni t.
Items
Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or port ion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or 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
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising Electrician
Owners Name,~~ .;;p, C;;;;::T. _ y D.
Address "3 'I T ~~/
Ci ty ~/ 'L-J-) Phone? '>"A.- 3'r%,
OI/NER INSTALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Ovn~Signature:
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~--------~------~-----------------~ 5.
DATE:,_ _. '1- ,?Z''?7
At,,,t.J.r! It' 2t12Zs.
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
Branch Circuits
....-- $ 40.00
$ 55.00
$ 80.00
volts see "B"
'~/. -
-/e:P..
,
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res'
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ .2.00 .
not included)
$
$
$
$
7"tf?- -b
2--
4'7.~
,
40.00
40.00
20.00
36.00
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