HomeMy WebLinkAboutPermit Electrical 2007-8-27
SPRINGFIELD
ZON
INITIALS
DATE
SOURCE
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City lob Number ("" ~t1CJ:5":f - 00 'T--::r-.s
1. LOCATION OF INSTALLATION: 3. COMPLETE FEE SCHEDULE BE'LOW
ycrs ;2l.{it. * 0
LEGAt. DESCRIPTION: ( ) 703. 361 V, ,0 7~. New Residential- Single or Multi-Family per dwelling unit,
_~i\..." t(p~,..~ ~ +-+, () Service Included
ih'B DESCRIPTION: v- 1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
~~
Permits are non-transferable and ewire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. CONTRACTOR INSTA,LLATION ONLY
/"1-- , -t-J \ ·
Electrical Contractor w., U.,~ ~/...c' "'!'t t.
Address
\)C) ~ ~\{Y
Phone (fq~ l::l.lJt
---
City J-:~ *
\J
Supervisor License Number q~ I - S
Expiration Date tfJ h ) 0- 't';/-
V I
Constr. Contr. Number , ~ t.
Expiration Date J I { l t t') ? -
{I' '
. . . . t
Signature of Supervlsmg E ectncmn
~
#.,,,v~
Owners Name _~~J
Address L{ 0 S- -Z l{ t L-..:
S ':>, ,,:::..'\.
City I ~ Phone
OWNER INSTALLATION
The installation is being made on pi"perty I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
-
Date
$106,00
$ 19,00
Each Manufact' d Home or
Modular Dwelling Service or
Feeder
$50.00
B. Services or Feeders - Installation, Alterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1 000 Volts see "B" above.
D. Branch Circuits
$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per Panel I J 7
One Circuit / $ 43.00 '1">
Each Additional Circuit or with "7
Service or Feeder Permit / $ 3.00 ~
,
E. Miscellaneous (Service/feeder not included) -Each Installation
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergyIResidential $ 25.00
Limited Energy/Commercial $ 45,00
Minimum Electric. Permit Inspection Fee is $45.00 + Surcharges . /
4. SUBTOTAL OF ABOVE 'Ib
8% State Surcharge '7 b~
]0% Administrative Fee 1/"0
5% Technology Fee i70
5b~
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application 8-06.doc