HomeMy WebLinkAboutPermit Electrical 1992-1-6
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225 FIFTH STREET ~<,".,c"
SPRINGFIELD, OREGON 97477 '0<""""''-"'
INSPECTION REQUEST: 726_},?:~?;~"'''~C' V/
OFFICE: 726-3759 ,c~iS,:::.&,,- ~.
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1. LOCATION OF INSTA~~TioN'~~~~\O~
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(~mb(W /25 a~4L/~'~NC)
LEGAL DESctuPTION v," -1,0
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JOB DESCRIPTION
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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
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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:
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DAT . " '.
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RECEI #: ? SI.:;-,g
RECEIVED BY: ......... L..----"~
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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
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