HomeMy WebLinkAboutPermit Electrical 1992-3-10
n <&quire 8jl8Clflc land U88
225 FIFTH STREET Zoning 00
SPRINGFIELD, OREGON,97477 I kh-r '
INSPECTION REOUEST:Auth'J.?e<A7MI 1.}o, ID~'"7 City Job Number
OFFICE: 726-3759 S~nmum, ~ ~L-/
3. COMPlETE FEE SCHEDULE BELOII
1000 sq.ft. or less
f:;(f(.I/; ~Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
1.
LOCATION OF INSTALLATiON
172n s" A"'~ +
LEGAL DESCRIPTION
/70 =') 3" ?,( nl, Z-DO
JOB DESCRIPTION
Sef'V;I,.e. t"blAMh
IJtiJ IJ C;..d
Permits are non-transferable and: expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
A. New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
2.- CONTRACTOR~INSTALLATION ONLY". ., B. Services or Feeders.
'"'7).,. , I . 'k i. c - I~~tallation, Alterations
Electrical Contract.o.r~v(~Ki.J'.dEC"!rtC 1/'1 Relocation:
AddressIO&)( IAJ 2.'ilot 200 amps or less
l? 201 amps to .400 amps
Ci ty LU t;,tAIU Phone!!> L( -::zr7'f L/- 2. 401 amps to 600 amps
o 601 amps to 1000 amps
Supervisor License Number <:fl. 71t; <( Over 1000 amps/volts
Reconnect Only
Expiration Date
/ () - / -4 z.
.~.
Constr Contr. Number 6 (o.~ 77
Expiration Date
1/- / ~ -q 2-
The 'ins talla t ion is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
------------------------~--------------
~ -/0 '-') Z
?'Cj 'i" I
//..>G.-J1
DATE:
RECEIPT II:
RECEIVED BY:
uni t.
Cost Sum
$ 85.00
$ 15.00
$ 40.00
or
$ 50.00 !};8 e>()
$ 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
.~4~rvis~cian/ .
--- r.v'" t/L; _ ,../ I i ~D. Branch Circui ts
Owners Nallie~1 IV/}ArA d. '
9()/J .I1~ / / ~(f /J 'ANew, Alterat~on or Extension Per Panel
Address 7 {; h N-UA k)fa /}/ U '
/? C\ One Circui t
Ci ty Y 1./ .?g-l.-f{ P Phone I{ /1' .5lI Each Addi tional
1/ Circuit or with Service
O\INER rnSTALLATION or Feeder Permi t .. "it
volts
$ 40.00
$ 55.00
$ 80.00
see "Bit
above
$ 35.00
$ ,2.00 a~
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 S 36.00
5. SUBTOTAL OF ABOVE ~tl)t!)
5% State Surcharge 2. '7"0
TOTAL ~D. "10