HomeMy WebLinkAboutPermit Electrical 1991-12-23
225 FIFTH STREET
SPRINGFIELD, . OREGON
INSPECTION REQUEST:
OFFICE: 726-3759.
97477
726-3769
1. LOCAT~N OF INSTALLATIO~, .\
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\~ LEGAL DESCRIr\ION
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JO~ DESCRIMION
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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.
Address
City
. ,
Expiration Date q .-.Vi -q-z.:....
Signature of Supervising Electrician
LJ~~..~~
~ers 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 Signature:
~~~~~--~-:-~::>------~~--------~-~--
RECEIP~#: -068'0 .
RECEIVED .DY: () t ~
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.3. COMPLETE FEE SCHEDULE BELOV
, ,~.
New Residential-Single or
Multi-Famil~ per dwelling unit.
Service Included: .
Items Cost
A.
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder .
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00 .
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
In~tallation, 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
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
. ;-:7//j~ A /~~~stallation, Alterations or
Electrical Contractor rt/ __ r // J /-=>1.x~loca tion:
{?:/7 Y At:: V 200 amps or less
J) / . -/j//V-7? 201 amps to 400 amps
~, Phone_,-yI' ));~401 amps to 600 amps
I - - - - .. 601 amps to 1000 amps
Supervisor License Number 3 7/.~ f Over 1000 amps/volts
/ / I Reconnec t Only
Expiration Date //)/ / /C? r~
Constr Contr. Numbe{ 0rn'f" I~
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or i rriga t ion .,.\----
Sign/Outline Lighting \
Limited Energy/Res
Limited Energy/Comm.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
40.00
40.00
20.00
36.00
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$
$
$
$
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