HomeMy WebLinkAboutPermit Electrical 1992-9-22
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225 FIFTH STREET ~:;;,\~~9. .nd 000r. ,,0 c.. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 9747//'I':ov,,". C____
INSPECTION REQUEST: 726-3769Zcniog_ Ci ty Job Number q:l,.:<.:<;z
OFFICE: 726-3759 ~'fQ: _.-----:
C."-...- _. :.'e ~_-GOMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALLATION;::.,-J"'\O'.~'" -
Ilb.t-, ~n.' n '. #': A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
LEGAL DESCRIPTION
\ I O~ 2,<, Lf I () i,(_fJ'::J
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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.
Electrical contractor~S POoLtiliJl, ffllln.-.
Address_P,t)~. IJ~1.--
CitY~OOJ ,Phone 141-.?-1.3~
Supervisor License Number 110 2 1,.,5;
Expiration Date
10-I-q~
OJj&4q
q - / -- q3
Constr Contr. Number
Expiration Date
The .installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE:
RECEIPT 11:
RECEIVED BY:
"Ih.:rI'3")"
(.,)./1
lOP.
Items
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
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 Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
Signature of Supervising Electrician
r/7~zf:. //J-~;}~
~ ~ .j) [ , ~D. Branch Circuits
Owners Name}Jl1YolY\J A. It r~
1JV\A--~~ w,Alteration
Address 30:31 II~~
City f'll?!lY\O. Phone 42~-2 ~50
OIlNER INSTALLATION
volts
$
$
$
see "B"
above
40.00
55.00
80.00
or Extension Per Panel
/ "J .st:-
$ 35.00 .7 J
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circui t or wi th Service_
or Feeder Permi tb
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$
0<-
2.00 10-
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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