HomeMy WebLinkAboutPermit Electrical 1994-7-20
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SPRINGFIELD
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225 FIFTH STREET ;approval ELECTRICAL
SPRINGFIELD, OREGON 97477 L D&
INSPEctION REQUEST: ". 726-3769 Z()nl~,/ q 4-
OFFICB: 726-3759:, OatG.1/2...cJ,
)3~OKPLETR ZEE SCHRDULRBRLOV
l.~q{;A:!'14N (i)lLIN~ALLAT~?{lzed SignatUre
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A.
Ney Residential-Single or
Multi-Family per dyelling unit.
Service Included:
~
. ' r!OB DES~,P.:J PTION r\ '\ 1000 sq. ft. or less
'---^ \() \ \. 'JV) '{\Jtf'~ Each addi tional 500
.. -., sq. ft or portion
Permits are non-transferable and expire thereof
if york is not started,yithln:'180_days _ ___ _ uEa~h.Manuf'd Home,Qr
of issuarice or if 'york is suspended for Modular Dwelling
180 days. Service or Feeder
, r
2. CONTRACTOR INSTALLATION ONLY
B. Services or Feeders
Instailation, Alterations
or Relocation:
"
Electri~al Contracior. -ROSE CORP
Address ,89976 DAY LANE
200 amps or less
201 amps to 400 amps
401 amps tG 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnec t Only "
City
Phone
nAn-OQOI1
FIIr.FNF
Supervisor License Number
1 56RS
Expiration Date
Constr Contr. Number
10/1/95
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It ems
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
\
50
$ 50..00
$ 60.00
'$100.00
$130.00
$300.00
$ 40.00
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5443 i~':'-
C. 'Temporary Services or'Feeders
Installation, Alteration or Relocation
Expi"ration Date
9/:m/9S
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
.
Signatur~perVi~ing Electrician
.. <<~-~v~ .
Ovners N.: _ U (lillf >, ];/JS1l1) D.
Address /0 q. C!uLfiiliIAaP
City ~~,Phone
O~TALLATION
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volt-ssee "B"
" .
above
Ney, Alteration or Extension Per Panel
Miscellaneous (Service/fe,eder
-Each installation
Pump ~r irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
The installatioh is beirig made on
property I oyn yhich is not intended
fo~ sale, lease or rent.
E.
Owners Signature:
~~;: l~y:~~1i10iO?JD-
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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