HomeMy WebLinkAboutPermit Electrical 2000-8-28
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225 FIFTH STREET . Date Q' " ).'is- tb ~
SPRINGFIELD,OREGON 97417. .' 1\v-J
INSPECTION REQUEST: t~~'~~~MgS,gnature '
OFFICE: 726-3759.
1.. LOCATI~ orA~STALLATJ;ON
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: LEGAL DESCMPTION./ .. .c,7;6
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/7 JOB DESCRjPTION . -Z ..~.-r---
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Permits are non~trans!€rable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days. .
ELECTRICAL PERMIT APPLICATION.
ei ty Job NumberOO .- c) / 3,D J -0 (
3.
COMPLETE FEE SCHEDULE BELOY
,(
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq.ft. or less S 85.00
Eath additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf~d Home or
Modular Dwelling.
Ser~ice or Feeder 5 40.00
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Elec tr i cal Con trac torSo nit r 0 I See u r i ty or Reloca t ion:
C i t Y 55 r;p.f1l., 1) .
7ifl-3(Js ()
Address P.O. Box 21009
Ci ty Euuene
Phone 461-5678
Supervisor License Number
Expiration Date
5 50.00
5 60.00
5100.00
5130.00
$300.00
S 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Cant!:. Number 65149
Expiration Date
6~28-00
-
Signaty.~e Of~'P rvising Electric~an
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--y
V. ...
Ovners Nam~ ~;dI~ D.
Address .s;::.:J-:2- ~ i?c/I
Phone
OVNER INSTALLATION
The installalion is being made on
property J own whic~ is not intended
for sale. lease or rerit.
Owners Signature:
----------~--7---~~-----~------------
DATE: O~ Z?>f oD . .
RECEIPT #: ]6 ::s;f!:i1 .
RECEIVED BY: ~~
S 40.00
S 55.00
S 80.00
see "B" 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
E.
s.
SUBTOTAL OF ABOVE
,% State Surcharge
3% Administrative Fee
TOTAL
S 35.00
5 2.00
not included:
I
S 40.00
5 40.00
S 20.00
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