HomeMy WebLinkAboutPermit Electrical 1992-8-12
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
5"2Q W, L!~~~J4L
LEGAL DESCRIPTION
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~Cj;!I'l(: \)/:~ID iJroj~t;"t a~ , . E,LECTRICAL PERMIT APPLICATION
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PrOltiJt, ~ <.01' require, ~;.. "'-.'.'aSi he f.'/I ()Z C") /l ./
. . Cff~c !Jl(jti I~NJ~Wer T I f):J ( t/
A\oflll1g
Dete et. t ." EE SCHEDULE BELOV
A~horgGdS: ~.
'9nt/l}re 'esidential:-Single or
. . Mul 1__ . '~elling unit.
. Service Included:
Items Cost
JOB DESCRIPTION
a tDb t5'-h7J:l~a'JP.-1 /f1Rnc::>/J.
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 rr-{~pJ'r1hJ t.fUn...
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
Relocation:
Address I S'Z,. 5 PtJYV('~ ~s: ~ (L~ r- 200 amps or less $ 50.00
~Lf2~?rSr~~ 201 amps to 400 amps' $ 60.00
City rf\)e. Phone 401 amps to 600 amps $100.00
30'1 S 601 amps to 1000 amps $130.00
Supervisor .License Number Over 1000 amps/volts $300.00
\0' arL..-- Reconnec ~ Only, $ 40.00
Expiration Date ,
C.
Cons t,r, , COI1tr. Num~er .C{.--U;-~ I "lD~"ZO be
Expi~a tion Da te /0(1 F::r V) 10/( Jq '--
_, Si7nature of Supervising Electrician
hL 'M~ j 7;~~
Owners NameFr<.trAJC I ~ +rrMt.. rc.;
Add ress :f;''Z. <7 -fA f ~ <! 'f7I./fL-"7JiAJ I n-<--
CitYa-uG-~ ~ Phone74"7 - 097.",
OVNER INSTALLATION
Theinstalla~ion is being made on
property I own which is not intended
for sale, lease or rent.
qwners Signature:
------------------------...:._-~:~.,-~~...:._------
DATE: . . ~;/~:5?~
RECEIPT #: 5g6?
RECEIVED. BY: ~~ ~-;.. ?/
//,
Temporary Services or.Fe~ders
.In~tallaii~n, Alter~tion or Relocation
200'amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "BIl
above
D.
Branch,Circui ts
New, Alteration or Extension Per Panel
.' J 0S.~
On~ Circuit . -' ~ $ 35.00
Each Additional
Circuit or with Service ,;2~
or Feeder Permi t I $ 2.00
E. H~sce11aneous (S~rvic~/leeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited ~nergy/R~s;$ 20.~0
Limited EnergyjCo~~$ 36.00
5. SUBTOTAL O~ ABOVE '3 '7,~
5% State Surcharge 1.8~
TOTAL 11 '3 '/? f?5