HomeMy WebLinkAboutPermit Electrical 1998-5-20
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Zoning . J . - . NOTICE:
oaten-l.;p,81 THIS PERMIT SHALL EXPIRE IF THE WORK
A~~ ~1lf8sJk~ *tJl HUHILED UNDER THIS PERMIT IS NOT
SPRINGFIELD, OREGOOOMMi~CED OR IS ABANDONED FOR
INSPECTION REQUESTANY~~~l1lfpERIOD
OFFICE: 726-3759 .
1. LOCATION OF INSTALLAJJON
-8~ 8eL'TL./~?P/7"G~./c::P
LEGAL DESCRIPTION
17Adi~'/?~A <?~'7t::>/
ELECTRICAL PERMIT APPLICATION
City Job Number~~~
3. COMPLETE FEE SCHEDULE BELOY
A.
New Residential-Single or
Multi-Family per dwelling unit.
. Service Included:
JOB DESCRIPTION. 1000 sq.ft. or less
W',q/V~ ~~ &!~~C~ ~~S:F'_~~ Each addi tional. 500
. . . sq. ft or portIon
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
2. CONTRACTOR INSTALLATION ONLYB.
Electrical Contractor /~p.#/?~ ~CEC? ..
Address~3 22..#-8. I'~W~~.
Ci tY~1'-~Phone~~'&y.6~
Supervisor License Number ~$."7 ~
Expiration Date ~~~~~
Constr Contr. Number ~~~
Expiration Date
7~ ~ · -9$.
Signature of Supervising Electrician
Owners Name 7:.c?'~~AV..~ ~~/~
Address ??~~? ~ W~
City. ~~~Phone ~'.I"Y~7"
. O~; INS~La?~' . -
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less /
201 amps to 400 amps
401 a~ps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only.
Items Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
$ 50.00 -5'c:::::'. ~
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
5. SUBTOTAL OF ABOVE
5% Stat~ Surcharge
3% Administrative Fee
TOTAL
200 amp~'oT less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B"above
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional.
Circuit or with Service
or Feeder Permit ? $ 2.00 /L:>
not includp.d)
E. . Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
D.
Branch Circuits
The installation is being made on
.. property I own ,,,hich is not intended
for sale, lease or rent.
Owners Signature:
----~--------7.---T---------------------
DATE: .. ~ U ,q-tj'
RECEIPT #: ( , IJ ].;tj.~ LJ' -
RECEIVED BY: /. W~7
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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