HomeMy WebLinkAboutPermit Electrical 1995-4-27
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225 FIFTH STREET z L--Oe.-. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 on 109 ~D~\ Lv
INSPECTION REQUEST: 726-3ni9l4-L,-?f.J' City Job Number ~-.J~)
OFFICE: 726-3759 ~ d..J V\A
Aultlonzed .,lg'ature~GOIII'l.E1;E....F.&E -SCHEDULE BELOII
1. LOCATION OF INSTALLATIO. N ""';;..
~~q /"'p~fi?~~ ~b A. New Residential-S1ngle or
- " - I Mult1-Famly per dwelhng Unlt.
I~~O~&IN ()\C\rn SerVlce Included: Items
JOIl DESCRIPTION
A/ h-'" ~..J <;" ~ k:>
Permits are non-tra~sferable and expire
if work is not started w1thin 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor AII'f.k \ Elfl'1~
Address IJ. Sw ::,~~+
Cityj\'\~r\'" Phone 41S-.1L",q
SuperVlsor License Number IfJnros
Expiration Date IO-I-qs:
Constr Contr. Number fa874.s
Expiration Date q-LJ-q~
.
-
Signature of Supervising Electrician
t2/~~/~~~
Owners Nam~1 Ao.f\ f1\+). D.
Address fS~ ~() ~r) ('\r\
City ~M, Phone~.l ~Lo\..o
OIINER ~~LATION
The installation is being made on
property I own Wh1Ch 1S not 1ntended
for sale, lease or rent
Owners Signature:
$lf,AlATE: j?/l/?
I..~CEIi>T I: Y--:2 7-~ S--
RECEIVED BY: ,7~-~' ----- -
1000 sq.ft. or less
Each add1t1ona1 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwell1ng
Service or Feeder
B. SerV1ces or Feeders
Installation, Alterat10ns
or Relocat1on:
Cost
Sum
85
~O
{
c!1
$ 85.00
$ 15.00
$ 40.00
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 Serv1ces or Feeders
Installat1on, Alteration or Relocat1on
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch C1 rcUl ts
$ 40.00
$ 55.00
-$ 80.00
volts see "B"
above
New, Alterat10n or Extension Per Panel
One C1rcu1t
Each Add1t1onal
CIrcuIt or vlth SerVIce
or Feeder Perm t
$ 35 00
$ 2.00
not 1ncluded}
Miscellaneous (Serv1ce/feeder
-Each 1nstallat1on
Pump or 1rr1gat1on
Slgn/Outl1ne L1ght1ng
L1m1ted Energy/Res
L1m1ted Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
'i'il'!/tIoS~
$
$
$
$
11'6 Cf:}
';;) '\::--
:;I,_~C::;
I~t U:i ,
40.00
40,00
20.00
36.00
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