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HomeMy WebLinkAboutPermit Electrical 1992-1-2 '. ,",:rJ\ ~ · ,'\'V,.... . "", .r.';'\' ~ I .\"r,""0 ~.. ~ '!\f(.lo'!l ..' ~~\ ,,).u, 225 FIFTH STREET ~i,:e;rJ".~'\:i\'}.\'\' ELECTRICAL PERMIT APPLICATION . SPRINGFIELD, OREGON 97477 ,~,;t (}~_::~~IO c\?\";r.,.. INSPECTION REQUEST: ' 726-37~9~~~'~('P\-'" City Job Number 9 //&-:<'2. OFFICE: 726-3759 _Cll,o\\O~~~6'C'jZ'> "".----...... "'~ \(lS)' , ,.. . ,. . 1-Q~ .. o-l~\' 3. COMP r ~E SCHEDULE BELOV ~o _\, 1.. LOCATION O! INSTALE1fJ:ION7..'J'ii"~"~~6\ 4~5~~) .#. . \/~/~) . New Residential-Single or . 09-\G~ ~{\~ Multi-Family per dwelling uni t. LEGAL DESCRI ION ~. Service Included:, /?~t72-"3?J--'3!fJ8~ 0/7 ~ ./ Items Cost Sum JOB DESCRIPTION o -W-l1\..O h ~ Permits are non-transferable and expire if work is not started within 180 days ,of issuance or if work is suspended for '180 days. 2. CONTRACTOR INSTALLATION ONLY , '.. Electrical contractorLf& p~g~. Address p.O. tusL J4g~ . . , Ci tY~llAlit\lL~LPhone '141 -, ;1.~3 b . ~J ' Supervisor License Number I" ~ b S Expi;-ation Date /0"'" I - q '.)....... Constr Contr. Number Og~*q 4 """"I -q ~ Expiration Date Signature of Supervising Electrician O,-l7LU~ .. , LV' .;v ~ . "7 ' Owners Name ~IY\O } It J~ Adclr.s~:q 5.~ ~ L r~ . CitY~~PhOne '14'7-Q'1'1'1 OllNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ---------------------------~----------- , DATE: I "'~.-=7 2. .RECEIPT #: ~~ ( RECEIVED BY: ~ ~ ' - r ~ ,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 B. ,Services or Feeders 'Installation, Alterations or Reloca tion: 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 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 New, Alteration or Extension Per Panel I , $ 35.00 35.00 One Ci.rcui t Each Additional . Circuit or with Service or Feeder Permit , $ 2.00 ~.oo E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limi ted Energy/Res $ 20.00 Li~ited Energy/Comm $36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ,37..00 I. g5 -~ a...J? 5