HomeMy WebLinkAboutPermit Electrical 1992-7-9
r=- -
--
~ ~","..........-Ia.:.LU
,
,,, .' . tt,
225 FIITH STREET i{}fjifl~prfJ/4cttttlBubrnin ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 IlfitiffNlJi.. ~-'8qu/",. Gd~lne1ollowl, q n()q' A (
INSPECTION REQUEST: 726-3769 10~/ID ~ol)lllNumber (-J.. I
OFFICE: 726-3759 h !-
Oete_ '. 3. ~u!lfbETE FEE SCHEDULE BELOV
1. LO~TION OF INSTAL~IO~~, /
, (l O~ n ,~ aJ\Ji J7"'re Residential-Single or
u' . er dwelling uni t.
Service Inclu ed:
I rl~~~~{i-~ 04lr2rf)
&O~~DES~WfiJ.
permi~s l::~ 'non~~e~~~d expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
E!ee:f
Electrical Contractor 2" Ijd~ r
Address .t 9'3 1fLoj.'J III ~
Phone lj'l:5 - () '1;1..:4..
City~,.~e..
Supervisor License
Expiration Date
Number :2 9' 7t:) S
/t) - /- P.:J-
Constr Contr. Number () '1.2. 'f /...
Expiration Date_ /..2- /,tJ~ y?....
Si"'~"P~~""
Owners Nanie\} :>\\f\ N"\'i\ 0 Qno
Address f\\n S r'\. ,.3\ ~~_oo-t
Ci ty ~4 ~ .... Phone
OVNER IN'JALLATION
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DA;;~----i)-~l1T~~;:J--':;~~-------------
RECEIPT #.' A--.I""lA~
RECEIVED im /')(J ~Q../ .
, -
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
B.
200 amps or 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
\m
l?-.rJ
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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permi t 4f,) $ 2.00 ill
no t included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$
$
$
$
, Sf orlC()
I P-..NJ
;-''''l'l~.C(')
40.00
40.00
20.00
36.00