HomeMy WebLinkAboutPermit Electrical 1993-5-20
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION ~QUEST: 726-3~9.?
OFFICE: 726-3759
Zoning
ELECTRICAL PERMIT APPLICATION
City Job Number ~ Cf3J3Jr
Authorizeci Sigr:latufs 3.._COKP.LETE_F.EE_ SCHEDULE BELOV
1. LO~ATION OF ~NST~LATION/ /
/9 j 7 . &A//l/lt Jj --?r1c/<771.f7}
LEGAL DESCRIPTION
A. New Residential-Single or
Multi-Family per'dwelling unit.
Service Included:
'i'
JOB qESCRIPTION
-l;D'\iq-~(-A ~ .,ltlf.' - ALZI, J/ W\ ~~~
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 B.
Elec tri cal Con trac tor(r~/2 c /. J "1 d dr...)
Address /.2J.e; ~.?T4 .
City &/_<:;'{J'p e
'v
Supervisor License
Phone b.f 7 - c:J ';)() Z
Number C!!.5;)..., ;ee.r)
/0- /-7~ ",
Expiration Date
Constr Contr. Number
. ..tI'
') () /"0 j'"
/lr.l-I-"77
Expiration Date
Signature of
'~ C:-:;Y
.'. ___ ./'--e::-
~
Owners Name
rician
~
Address
City Phone
OVNER INSTALLATION
The installation is beirig made on
property I own which is not intended
for sale, lease or rent.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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
Items
Cost.
Sum
$ 85.00
$ 15,00
$ 40,00
$ 50,00
$ 60.00
$100.00
$130.00
$300.00
$ 40,00
C.
Temporary Services or'Feeders
Installation, Alteration or Relocati6n
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL '
$ 40,00
$ 55,00
$ 80,00
volts see "B" above
New, Alteration or Extension Per Panel
$ 35.00
$ .2.00 '
E. Miscellaneous (Service/feeder
-Each installation
Pump' or irrigation
Sign/Outline Lighting
~Limited Energy/Res .
Limited Energy/Comm
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
Ovners Signature:
---------------------------------------
DATE: 0- - 2.0 ~ C(:3
i\!s"r..u'1' i: ~0 2> =,
RECEIVED BY: ~,
D.
Branch Circuits
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
not included)
$ 40.00
$ 40.00
,$ 20,00
$ 36,00
20
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I -60
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