HomeMy WebLinkAboutPermit Electrical 2005-10-17
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION ",0'Q~\
City Job Number C/9m2t?t1S-CJ/2-tJ 7 Date /tJ// 7/4ZG~eo.0
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A. New Residential ;;-~ngleor Iv. %~lilY per, d'~elIing u~it.
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LEGAL DESCRIPTION
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JOB DESCRIPTIO~
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Permits are non-transfera.{.e a~ expire if work is
" not started within 180 days of issuance or if work is
Suspended for 180 days.
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Electrical Contractor &fAf j{j~L [1-(('''
Address fo&t fie -
City (~( ( t-Jl:' I / f7~~
Service Included
1000 sq, ft. orless
Each additional 500 sq, ft. or
portion thereof
$106.00
$ 19,00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B.
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
~W"J/th 601 Amps to 1000 Amps
W' U -0 /' I lOver 1000 AmpsN olts
Reconnect Only
$ 63,00
$ 75.00
$125.00
$163,00
$375,00
$ 50,00
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Expiration Date /0 -() 1- 0'7
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Constr. Contr. Number '::>0 1'-6
Expiration Date <(. 06'-07
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Owners Name S--YCMJ'~.
Address ~O ~d-C..&D~
City 5;/7 Phone ~ - ~~
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Supervisor License Number
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
c.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
$ 50,00
$ 69.00
$100,00
O~e.~..?OOi\.mps.orlOOO Volts see "B" above.
D.Branch Circuits
New Alteration or Extension Per Panel
One Circuit I
Each Additional Circuit or with Jp...
Service or Feeder Permit IV
$ 43.00 4jlrl
$ 3,00 30. ~
E.
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50,00
$ 50,00
$ 25.00
$ 45,00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
7'3. fX)
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7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application I-03.doc