HomeMy WebLinkAboutPermit Electrical 1991-6-4
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
!5q {o ~c~ OA-
~'O ~~tsN~ Dto ,3CQ
, . \ JOB, D~WUPTION ^ ^ <f
'_~~ l ~ lJ ,r J..LJL.l" A
.permi6)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
Electrical contractorfJA'QQlG~~ '
Address -3<P /J. O~\'
Ci ty e~~ ,:01.--. , Phone
CI
Supervisor License Number
C'&'r- ~'f </9
67Y-S
Expiration Date I {) ..../ '- 9 ~
, Constr Contr. Number d- () -/7 - C.
Expiration Date /tJ-/- 9/
Sig~,tureof Supervisi~g Electrician
, ~~.J~ r~ .,
, Owners Name '
Address
City
Phone
OVNER INSTALLATION
The installation is being, made on
property I own which is not intended
for sale, lease or rent.
Owners Signa ture:'
D~~~~--~-~-~lC--~~-------------
RECEIPT i: ILC)L~
RECEIVED BY: 05l'>~
,
ELECTRICAL PERMIT APPLICATION
City 'Job ,Number q \()~ 4.9_/
3.
COMPLETE FEE SCHEDULE BELOV
Sum
1500 sq~ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 35.00
gJ;-
/j:-
B. 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.
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 35.00
$ 40.00
$ 80.00
see "B"
above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
, . Two. to ten Circui ts
Each Addt'l ten or
portion thereof
$ 35.00
$ 50.00
$ 15.00
E.
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation,'
Sign/Outline Lighting
, Signal Circui t or
limited energy panel
5.
$ 36.00
$ 36.00
$ 36.00
(T) -:-'
" L.;..t '-"
V(_
\05 C)C)
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL