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HomeMy WebLinkAboutPermit Electrical 1991-9-9 ,,:',';fO\\O'llif>~ ' ~ ;'225 FIFTH STREET .,..~'),.".,A \ys,~~:;;~, \.l'-"~ELECTRICAL PERMIT APPLICATION SPRINGFIELD,OREGON 97477 , ...; " e'" ", <"" ':.')" , " INSPECTION REQUEST: 726,,,;3769"", " ~),( 1\\,' ,.- J",,_' d ty Job Number 9 ~/ Y''3'"2-.. OFFICE: 726-3759 " ' ~\L...?~,_'--' ~(\' TE FEE SCHEDULE BELOV ___, ,1. LOCATION OF INS]'ALLATION fA.. V\W\ _.-~...-' ' ~th-=3 W" LE,H-/ ~~~~ gtR~idential-Single or ,-' Multi-Family per dwelling unit. Service Included: LEGAL DESCRIPTION /?-{??'-:<7"'7'~- ~~6C:::. ,r d:9B DES~IPTIO~ ,-~lOI'f'...-/' Permi ts a~non:-transferable and expire, if work is not started within 180 days of issuance or if work is, suspended for i80 days. I~J.~.-. ,- Items Cost Sum 1000 sq. ft. or less Each additional 500 sq.ft or portion thereof E~th Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders Installation, Alterations or Relocation: Electrical Contractor/~~z:;;;.N r~" Address .J'~ ~' ?t:?~ Ci tYE"~~.,;.E Phone 3 Y<-{;6~ Supervisor License Number )C -43 7,S'I. Expiration Date ~ laJL'jQ3 200 amps ~r less' 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps ,Over 1000 amps/volts Reconnect Only $ 50;00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Constr Contr. Number).::' &4& 1<6 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date~ 314/er:L 200 amps or less 201 amps to 400 amps Over 401 to ~OOamps Over 600 amps or 1000 $ 40.00 $ 55.00 $ 80.00 volts see "B" above :ii1:~f;;;;~? "D.' Owners Nanie /E'.h"/e,,:,,~~'- 4-~~?5' AddressQ()&'){ , \?l2-~ City-t:W 51 OXIG~one '4k=l-qld)\ ' , , Branch Circuits New, Alteration or Extension Per Panel OVNER INSTALLATION One Ci.rcui t Each Add,i t ional Circuit or with Service , or Feede~Permit $ 35.00 $ 2.00 The installation is being-made on property I own which is not intended for sale, lease, ~i'reh t . E. Miscellarteous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting ~$ 40.00 t.n::> Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 , Owners Signature: ~A~i~----~~2:1~~r--~-~~--~---------- :~~~Di~Y~i~~ 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL YOr~, 2..D'e:;tI' Y2,.~ v (2, .