HomeMy WebLinkAboutPermit Electrical 1991-1-29
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225 FIFTH STREET
,SPRINGFIELD, OREGON 97477
INSPEC'l'ION REQUEST: 726-3769
OFFICE: 726-3759
1 ~ LOCATION OF ~~ALLATION An
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LEG~ DESCRIPTION '0 ~~
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Permits~e non-transferable and expire
if work is not started within 180 days
, of i~suance or if work is suspen~ed for
180 days.
2. CONTRAC'l'OR INSTALLATI9N ONLY B.
Electrical Con tractorfW,roo.li.9, Q,lli.f:-,.
Address ~ ~ 0'N t \ \ . _
City~~~_rl)\\\o, Phone fl4-104tA~
Supervisor License Number "'5 ~ \.0 S
. , Expiration Da'te
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Constr Coritr. Number . \0 QDO 5
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";1 ,
.PRI""CFiELO ,....,..' "'.
ELECTR!CALPERHIT APPLICATION
Ci ty Job Number q n 103 '7
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Rulti-Family per dwelling unit.
'Service Included:
Items.
1500 sq.ft. or less
Each additional 500
sq. ft or portion
thereof '
. Each Manuf' d Home or
Modular Dwelling _ ~
Service 'or Feeder ()!
$ 15.00 '"7'--~ 9/J
$ 35~~.
. '
Services or Feeders (10 Branch Circuits
included). Installation, Alterations
or Relocation:
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 .amps to 1000 amps
Over 1000 amps/volts
Reconnec t Only ,
$ 35.00
$ 60.00
$90.00 '.
$130.00
$300.00
$ 35.00
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C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Signature of Supervising Electrician Over 401 to'600'amps $ 80.00
~~~fl,;{!) ~___r!!. Over 600 amps or' 1000. vol ts see liB" above
v ? 1-' f\ . l' D. Branch Circuits
Owners Nam\.J;'\\\\~\A <\. \"<~C\..Q.-O \\~' , .
.0. Q.. 01 Q" \N\ : -\ "...I New, '~l teration or Extension Per Panel
Address r) v r ') <..,) ..). \' \ \{\ffi.l (\:~ '
. f\.. f".1."\. _ (\ (\. . ' One Circui t
City ~ ~~OJ ~Phone f)~to- ~'TWO to ten Circuits
. Each Addt'l ten or
. portlon thereof
E. Miscellaneous (Service/feeder not included)
-Each installation . '
Pump or irrigation $ 36.00
Sign/Outline Lighting' $ 36.00
Signal Circuit or
limited energy panel
Expiration Date
, OWER INSTALLATION.
The installation is being made on
property ,1 own which is no~ intended
. fo~ sale, lease or rent.
Ovners Signature:
------------------11/~-----------------
DATE: 1~(Jg-~u' ' '.
RECEIPT I: ' . , . M I "frO
RECEIVED BY: (~1/.m_)
5.
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$ 35.00
$.50.00
$ 15.00
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
S 36.00
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