HomeMy WebLinkAboutPermit Electrical 1996-1-18
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97477 ".rti'onz&d Slgnature_ I
726-3769
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. ~OCATION OF INSTALLATION
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I LEGAL DESCRIPTION
,03 dS 33- I I z.(J7)
JOB DESCRIPTION ,.
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Permlts are non-transferable and explre
lf work lS not started wlthln 180 days
of lssuance or lf work lS suspended for
180 days
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2. CONTRACTOR INSTALLATION ONLY B.
E1ectnca1 Contractor c,~~~ PDo"t~j1--4-~
Address P.O, fuJ, ,tLgd-, .
I
CltY~r\J~~f~d. \,
Supervlsor Llcense Number
Explratlon Date
Phone '74' 1-1-.13lc
Ih2bS
10-1-%'
DJJ g4q
q -I-HJ
Constr Contr. Number
Explratlon Date
Slgnature of Supervlslng Electrlclan
aA~~a.~
Owners Name (\ t b ~rU: ;:rJ'U'iil\~ ~ ."iYU-
Address...Li11 (lo [1'\.-to \Y\rYIII'l ~ )
Cl ty~~rL Phone 1'J..b - 0 b-tn
O~ INf+ALLATION
The lnstallatlon lS belng made on
property I own WhlCh lS not lntended
for sale, lease or rent
Qvners Slgnature:
-----------~---------------------------
DATE: I~ I 0":- q (/1_
RECEIFT #: Ud----() /I U
lJT'f"VTlron RY. \L \ ... dV\ At ,H-~/)
ELECTRICAL PERMIT APPLICATION
Clty Job Number
y, (0 rm7C
3, COMPLETE FEE SCHEDULE BELO\I
A, New Resldentlal-Slng1e or
Multl-Famlly per dwelllng unlt
SerVlce Included
Items Cost
Sum
1000 sq ft or less
Each addltlonal 500
sq. ft or portlon
thereof
Each Manuf'd Home or
Modular Dwelllng
Servlce or Feeder
$ 85.00
$ 15.00
$ 40 00
SerVlces or Feeders
Instal1atlon, Alteratlons
or Re10ca tlOno
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 5'0,00
$ 60.00
$100 00
$130.00
$300.00
$ 40.00
C,
Temporary Servlces or Feeders
Instal1atlon, Alteratlon or Relocatlon
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 "B" above
D.
Branch Clrcul ts
New, Alteratlon or Extenslon Per Panel
One CHCUl t
Each Addltlonal
Clrcult or wIth Servlce
or Feeder Permlt ~
$ 35 00
$ 2 00 ~ OD
E. Mlscellaneous (Servlce/feeder not'lncluded)
-Each lnstallatlon
Pump or lrrlgatlon $ 40 00
Slgn/Outllne Llghtlng $ 40 00
Llmlted Energy/Res $ 20.00
Llmlted Energy/Comm $ 36,00
5. SUBTOTAL OF ABOVE 54, DO
5% State Surcharge :i-. '"It)
3% Admlnlstratlve Fee I ,_6\,
, 00"-'
TOTAL ." <;I . ",' 'L.>