HomeMy WebLinkAboutPermit Electrical 1996-10-17
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225 ,,~~ H. STREET AI1l.horized Signature jJ . fV\
SPRINGFIELD, OREGON 974//
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
2. CONTRACTOR INSTALLATION ONLY .B. Services or Feeders
Installation, Alterations
Electrical Contractor}J,l>l..) LJA( 'Sltc...-r. or Relocation:
JJ... -1--\ .., ''"'D~
Address I eo' D;2 L.) I ~l>.l:>=. ,200 amps or less 0' $ 50.00 ~;.;
201 amps to 400 amps $ 60.00
Ci ty Eu Cl r- \.\ ~ Phone L9-P.lo' ~ ,~L:S" 401 amps to. 600 amps $100.00
~ 601 amps to 1000 amps $130.00
Supervisor License Number -32'K"2 ~ Over 1000 amps/volts $300.00
/ Reconnect Only $ 40.00
Expiration Date 10"~
C. Temporary Services or Feeders
Constr Contr. Number ~()'/~~'-- Installation, Alteration or Relocation
Expiration Date ID/97 ,200 amps"oT less $ 40.00
. / 201 amps to 400 amps $ 55.00
t41. ~~perViSing Electrician Over 401 to 600 amps $ 80.00
.T"-\-) . Over 600 amps or 1000 volts see "B" above
. t-t' \ ,,^...lL. f...1 D Branch Ci rcui ts "
Owners Name \ -I,+.nU\11, f}J~
Address \'Zl'ln l"\() ~,6t K ew, Alteration or Extension Per Panel
~. ~I One Circuit $ 35.00
City, . ~J \L Phone Each Addi tional
- Circuit or with Service ~
OVNER I ALLATION or Feeder Permi t c9 $ 2.00 H
The installation is being made on E. Miscellaneous (Service/feeder not included)
property I own which is not intended -Each installation
for sale, lease or rent. Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
1.
LOCATION oy INSTALLATION<:",\-
1.~70 ~o'-'\\-\- A ....::--\/U.T'. A.
Iff!' D~~~ \10'3303l0lotcOl
JOB DESCRIPTION ~
R F \,I"l r ('I -t r f,E.1Z..1I1 c..,E -rill",>\;",. ilil rz.t:I... t.r.ili
of -l:~ &.td..it.:la t.o ~ ~f\\""" E;.~n~.
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
,
Owners Signature:
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RECEIVED BY: -. - V ~
~
XLECTR!CAL PERKIT APPLICATION
Ci ty Job Number Q, lo \2.- ~
3.
COMPLETE FEE SCHEDULE BELOll
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular_ 'Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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