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HomeMy WebLinkAboutPermit Electrical 1991-3-29 225 FIFrU STREET SPRINGFIELD, OREGON 97477 iNSPECTION REQUEST: ,726-3769 OFFICE: ' '726-3759 1. LOC^fS~ ~F ~~~ ELECTRICAL PERMIT APPLICATION City Job Number 'Q\O\9<?:' 3. COMPLETE PEE SCUEDULE BELOY ~~~'d6~~~ tJloQ.oO A. New Residential-Single or Multi-Family per dwelling unit. Service Included: ""~B Q~CRIPTION ' I \" . t-" OL)/ . ;er:: a~e 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~al contractorL NV\f\~ wt "AddressQa ~;;rJ-'-'- , City~ ~J\L-" ,PhoneJalo~lffi Supervisor License Number ~ ~~~ \O\{ ( I q~ Gonstr Contr. Number 'CJ.3 \ () J '\0/5/Q / Expiration Date Items Cost Sum, 1500 sq.ft. or less $ 85.00 8fj Each additional 500 sq. ft or portion ~ "30 thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 35.00 Services or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: 100 amps or less 101 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 35.00, $ 60..00 $ 90.00 $130.00 $300.00 $ 35.00 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date Signature of Supervising,Electrician i:e~f~~ Address. A4G.. ~ .(b 1\ Y'.u'Xi '~-' . Ci ty\), '~1 ~ ':, Phone 'le.f{)~.~ q,)? OVNER INSTALLATION The installation is being. made on property I ,own which is not intended , for sale, lease or rent. Owners Signature: ~A~~~----(3;r~L1j1'1rJr----~---------- RECEIPT I: I I (ff) V'l'-1 RECEIVED BY: ~/ .' 200 amps or less $ 35.00 201 amps to 400 amps $ 40.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" D. Branch Circuits above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Signal Circuit or limit~denergy panel One Circuit , ,Two to ten Circui ts Each Addt'l ten or portion thereof E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 $ 50.00 $ 15.00 not included)" $ 36.00 $ 36.00 $ 36.00 \ \ '\),cO "lQ . "--5- --.l.fl () . ~~