HomeMy WebLinkAboutPermit Electrical 1992-8-12
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225 FIFTH STREET ~pp~~~tnddoe:~~:Ssu~~ ELECTRICAL PERHITAPPLICATIO(j'j
SPRINGFIELD, OREGON 97477 f'r equ/re s~fZa.s the foli n n \\
INSPECTION REQUEST: 7~6-37 iflg ~ lancJ~~ Job Number '-"'to\'
OFFICE: 729..-37~~ flta ',0,,:/
~llJ~ A~~ _7~ COMPLETE FEE SCHEDULE BELOY
1. LOC ION OF INSTALLATIO~ Signature
~eAlAJItA//At- ~t.,{/.P. New Residential-Single or
.; eeA/II/Ir--A/111t- Cbf/re~ - ti-Family per dwelling unit.
\rf6~SFf~~N 05<6C)() Service Included: Items Cost
JOB DESCRIPTION '
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Permits 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 B.
Electrical Contractor 51Jt/e CJA../l3t.GCt':
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations or
, Reloca tion:
Address jJ() AdX /L3/~~ 200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
City E/(/irbY E... Phone ~ 'It! f9Z7 401 amps to 600 amps $100.00 ,
601 amps to 1000 amps $130.00
Supervisor License Number <~~.5 Over 1000 amps/volts $300.00
/#-/-fZ Reconnect Only $ 40.00
Expiration Date
Constr Contr. Number '2/J qqc.
Expiration Date /1/-1-92.
Owner
Address
City Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~----P5-~\-~~-cr~-~~-~---
RECEIPT #: kJ!'. - ~.~ n
RECEIVED BY: r~ /J U'~:J, - -
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 ~r 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B"above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Ci-rcui t/
Each Additional
Circuit or with ServiS1
or Feeder Permit, ~
$ 35.00 , g~tZl
$2_~ pO -fp.t()
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 $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
4/'$
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_ 1./'2 . (J~
1.7' -