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HomeMy WebLinkAboutPermit Electrical 1992-1-6 ..~:0Ic}.'Q..}) ~\ "~~~""..-:;.""r..;. . 'r;l~:~;;>': . 225 FIFTH STREET ~<,".,c" SPRINGFIELD, OREGON 97477 '0<""""''-"' INSPECTION REQUEST: 726_},?:~?;~"'''~C' V/ OFFICE: 726-3759 ,c~iS,:::.&,,- ~. ..r,...<:J,...\\."', 3 -\ ''\''"." ,./ e 1. LOCATION OF INSTA~~TioN'~~~~\O~ ,2- ?(<>) elf""",,, / /-IN....V ",<e (~mb(W /25 a~4L/~'~NC) LEGAL DESctuPTION v," -1,0 >$.\\0\ /77?3-<.-:>-.r< . ~4/d:iti:!> I' JOB DESCRIPTION ..!::../P.l" , INb~ h<>f( -;,' 8,..1'<<. t",.. L7R~ - . . Permits are non-transferable and expire if vork is not started vi thin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical 'Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name -:::)c\f _ \'frl.-l vI - I Address ::1-3"'3 Ckc<K.vuc. L"",,- City 'S~V'lJ-.i' p.q Phone T2C,-4:0tC:, OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: ---t~~t#l~_:=~~~-------------- 2 .'J .. DAT . " '. , """ RECEI #: ? SI.:;-,g RECEIVED BY: ......... L..----"~ .~ ty Job Number "7"2L>:O/d. Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items Cos t Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 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 ,C,o-60 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 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 Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Add it iona1 Circuit or vith Service or Feeder Permit TIY $ 2.00 '--IO.CD E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL q.?J,'-' 4'.. So<:> qQSO