HomeMy WebLinkAboutPermit Electrical 1996-6-12
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Zor"na , J oJ ELECTRICAL PERKIT APP~ON qs
97471 . (\1
726-376~t", (g ['1; cuP Ci ty Job Number V\
AuthOl'l.1.ad Slcnatura *7n/\ --
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1. LOCAT~ON OF INSTALLATION
.L:..s.~ Ufl1<-Tf+ "ff" ~4!jj)CI-""1 A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
225 r~r.a STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
I ~.oE~ION' r-I'VI
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JOB DESCRIPTION
ALARM SYSTFM
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
-,
180/'days.
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2.' CONTRACTOR INSTALLATION ONLY
Electrical ContractorADT SECURITY
Address_ 1501 Pearl 'iU.e.P>, s"'..tP R
CitYEu~ene. 97402
Phone(503)342-1111
Supervisor License Number R-1777TT.F
Expiration Date IO-I-On
Constr Contr. Number 59944
Expiration Date 4/79
Signature of Supervising Electrician'
, ~fL-/
Owners Name Ii7r)/)EK.JJE' 13.e"c.t=..... . ~T1J..1llJJ
Address (",.,,~ /.. 1(ltf'1H "A-" S'frt=t-"'C...
Ci tY-.Si8 J) c::r 74:72. Phone.S!li- 'J w,. 0/d1
OVNER INSTALLATION
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular 'Dwelling
Service or Feeder
B. 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 Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. 'Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00 ~
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
DA~E~-----rti:-r~-~~Zt?- ~~~I?-
RECEIPT II: <:::J-.n: ... -
RECEIVEDBY:,(._I)~~,}- , -
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5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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