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HomeMy WebLinkAboutPermit Electrical 1991-12-23 225 FIFTH STREET . .SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726~3759 1. " LOCATION OF I~STALLATIpN . :z-.3z 7C'..-1 f,aiV' V (,{ t> _ LEGltJ,.~SCRIPTION t 70'/&( I z- 37JJ 0-0 JOB DESCRIPTION , ' 'bVv. e iVC'\A (-+-- Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vorkis. suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical ContractorCCUVlP!Jt{! 6(t{:- Address rO. 130'/ 2ft; /. '4 Ci ty NdJ+&VVi ({ e.- Phone -iJi. 070S Supervisor License Number ~ro G 0 S /0(((1-:/ Expiration Date Constr Contr. Number :g;;e-:?7/1Cf5 Expiration Date -tf'; /?7t5/2l//'fZ-- Signature of Supervising Electrician #L- &~.fjj .... V ,I Ovners Name (I ftvtts !..j{Jl >'" ; Add. r2Z' _ 2-2~ { c.l-z~v t/ LA- f:, Le" CityJ(J'PLd Phone 17'-177 OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: --------~--1------------~-------------- DATE: 12-. Z/3 1 q / r.. .... RECEIPT jj: ?;, '::>;8'/ RECEIVED BY: ('L~ \. City Job Number 3. , . . COMPLETE FEE SCHEDULE BELOV A. Nev Residential-Single or Multi-Family per d~elling unit. Service Included: 100q sq. ft. or less Each additional 500 sq. ft ~r portion thereof . Each Manuf'd Home or Modular Dvelling Se~vice or Feeder . Items Cost Sum $ 85.00 $ 15.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: ,. , B. 200 amps or less 201 amps to 400 amps 401 amps to 600 a~ps 601 amps to 1000 amps Over 1000 amps/volts R.econnect Only C. $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 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 D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 volts see "B" above Nev, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Circuit I Each Additional Circuit or vith Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 ~,D[) $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 55-a? 1JJJ,1'1!:;> 3(,,-70