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HomeMy WebLinkAboutPermit Electrical 1991-2-20 r; , . , ,'., , ~/:i" SPR.~IELO 225 FIPTR STREET ,SPRINGFIELD, OREGON 97477 INSPECTION REQUEST:' 726-3769 OFFICE: 726-3759 ELECTRICAL PERKrr APPUCATION Ci ty Job Number' q { 0 ( ()l ,1~,'LO~~~l~h~~\~ ,~\() .. LEGAI,...D~cRIlTION . O. . ~ ,\'R D.d..{)~\\ ()\'a \\ ~ JOB D~s..CRIP'{ION ' ,. ~" t' ,}('..[\ ~ i')Q )(\ ') ~ ~ f). ~ ' permit~' are non-:ransferable \J:d expire, if work is not started within 180 days of issuance or if work is, suspen~ed for, 180 days. 2. CONTRACTOR INSTALLATI!)N ONLY' 3. COMPLETE FEE SCIlEDULE' BELOV A., New Res~dential-Single or ' Multi-Family per dwelling unit.' , "Service Included:, '. Items Cost , Sum.' B. 1500 sq.ft. or less $ 85.00 Each additional 500 sq. ft 'or. portion thereof ' $' 15.00 Each Manuf'd Home or Modular Dwelling, IA , 'n(~' Service 'or Feeder ,~. $ 35.00, ~ .}: Services or Feeders (10 Branch Circuits' , includ~d)~ Installation, Alter~tions ' or Reloca tion: : ' Electrical Contractor. Address City Phone 100'amps or less 101 amps to 400 ampsi 401 amps to 600 amps , , 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 35.00 $' 60.00 .. , $ 90. (,)0 " ' $130.00 $300.00' $ 35.00 ..' Supervisor License Number , Expiration Da'te Constr Contr. Number C. Temporary ServiceS or Feeders , Installation, Alteration or Relocation ~xpiration Date 'C 200 amps or less , $ 35.00 201 amps to 400 amps $,40.00, Signature of Supervising Electrician Over 401 to' 600 amps $ 80.00 " ' Over 600 amps or'1000 vol ts see '''B'' , above ~. . \i~ '. (\ r U",,' \--..f\ 111 tr-D:. Bran~h ~ircui ts Owners Name..! V\)\)) ~ \l.. ~'1 1\ \ )\ \ l\.LZ..) ~ , , :f\\A.-c2... ~ ::t.\<'~4=\c:(.... New; 'Alteratio~ or Extension Per Panel' Address a. ":\~l..'f\ U\ (5': .....J\...V '. ~' (Nl '~l Ll.. -, ':)lo' .~ c::: One Circui t Ci ty ,\ "- Phone 1" I-\~J ''-.,)--J Two to ten Circui ts - \ , ' , ' Each Addt'l ten or OWER IN5nLLATION', . '" portion thereof' $ 35.00 $,.50.00 $ 15.00 The installation is being made on property ,I own which is not intended for salet-,. ~ease or rent. ' \.0\\\ 6ttU~ \\J\.\-\. ~ ' .~~4;;;t:'.B~ . ~;~-----~~d(Tq7 RECEIPT I: -1-, _ ICI <~ RECEIVED ,BY: r ~ /) { /0/\ . E. Miscellaneous (Service/feeder not included) -Each installation'. ' Pump 'or irrigation Sign/Outline Lighting' " Sign~l Circuit or limited energy panel $ 36.00 $ 36.00 ' , , , --------- , , 5. SUBTOTAL OF ABOVE 5% State Surcharge, , TOTAL $ 36.00 f)D~ J)~"~