HomeMy WebLinkAboutPermit Electrical 1993-6-29
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225 FIFTH STREET 1\,\6 toilowin~:;:~:G\ :\iJ'-iu\\l; ,J:-~
SPRINGFIELD, OREGON 95/UJttd '1"
INSPECTION REQUEST: a~g-j769 '~~~
OFFICE: 726-3759 z.on\f\g---~
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1. LQCAT!.gN~F W~T~10N ' n'3\Ufe~
L\-{)JPX ) (~{l)'UL~t~()ZrrPl n V-L A. New Residential-Single or
,- - - .. - Multi-Family per dwelling unit.
\-l~ ~\f4-~O()46cc) Service Included: Items Cost
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(1f19B DESCW1'ION, , -I-
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ELECTRICAL PERMIT APPLICATION
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City Job Number
Sum
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
.180 days.
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
, Service or Feeder
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations or,
Electrical Contractor Scofield Electric Co. Relocation:
Address PO Box 276S
Ci tyEugene
Phone
686-8612
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
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Supervisor License Number
S08S
Expiration Date
10-1-92
Constr Contr. Number
38702
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
12-21-92
200 amps or less
201 ampir to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above
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Owners v~ame~ ()O 'rl D )~ J 0 ~
Address 4D ~ " 0 ~loiL
City ~~ Ph:n.
OVNER INSTALLATION
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit 1
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00 S~
$ 2.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
~ATE~---t(J-~~2:f-~~~~--~-----~---~
RECEIPT i: f _ - V r-. '-" \ "I rY\
RECEIVED BY: ~0 /C'( \.: .
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
\ ~S .00
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Owners Signature: