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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