HomeMy WebLinkAboutPermit Electrical 1995-4-17
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97477 0' ~9-tJ-
726-3"469.orILa:l "'9"~'U
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
~ ~ .LJ. 7 c!.-A#J.-Rb R~.I! :Di2,
LEGAL DESCRIFTION
I ~ D 1- 0(0 ad ()C).,100
JO'Y- DESCRIPTION ~ .'2.. ___
A/7M& 5" PK" IltJt('r/ J;J
Permits are non-tra~sferable and expIre
if work is not started WIthin 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor At/h) rlrrlelc-
Address ) J ~10 _=<.~(.--I-
City IV1~A<-
Phone 415~..21.".C)
Supervisor License Number
I no(o ~
ExpiratIon Date In-/-~~
Constr Contr. Number (o'R7Lf~
ExpHatlon Date
CJ-l/-9,\
Signature of Supervising Electrician
?f"//C4{lf -~~~~
, Owners Name _~~J tl _ 'BrIt. ~ Jl'll' ~ . .
Address ~lil~ 00. 1JVlJ. 0t-
Ci ty ~rL Phone ~~IJC1lit-
O~~STALLATION
The Installation IS beIng made on
property I own WhICh IS not Intended
for sale, lease or rent
Owners Signature:
-------------------~------~-----
DATE: ~ ~'IJ~I~
RECEIPT 11: \ \014 /,
RECEIVED BY:l~ lU~('----) .
ELE~l~CAL PERMIT APPLICATION
CIty Job Number ~~~ ~~~
3. COMPLETE FEE SCHEDULE BELOIl
A. New Residential-SIngle or
MultI-FamIly per dwellIng unl t.
SerVIce Included:
Items Cost Sum
1000 sq ft or less $ 85.00 JffD
Each addItIonal 500
sq ft or portlon !J.. ?jJ 14
thereof $ 15 00
Each Manuf'd Home or
Modular DwellIng
Service or Feeder $ 40.00
B. SerVIces or Feeders
InstallatIon, Alterations
or RelocatIon:
200 amps or less $ 50.00
201 amps to 400 amps $ 60,00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300 00
Reconnect Only $ 40,00
C. Temporary SerVIces or Feeders
Installatlon, Alteration or RelocatIon
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Clrcults
$ 40.00
$ 55.00
$ 80.00
see liB"
above
New, AlteratIon or ExtenSIon Per Panel
One ClrCUl t
Each Addl tlonal
CIrCUIt or WIth SerVIce
or Feeder Permlt
E.
MIscellaneous (ServIce/feeder
-Each InstallatIon
Pump or lrrlgatlon
Slgn/Outllne LIghtIng
Llmlted Energy/Res
Llmlted Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
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12Jhrl-
$ 35 00
$ 2.00
not lncluded)
$ 40.00
$ 40 00
$ 20,00
$ 36.00
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