HomeMy WebLinkAboutPermit Electrical 1992-12-15
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, '" b 't'ed has the following . ~
, The.folloWidngIP~~J~~\ ~:q~!\r:~~ecifiC landElhECTRICAL PERMIT APPLICATION
97/-77 zonmg,an 00",' q~' C Co
Of CIDproval. ./J
726-3769 'Zonina ~'" p, ( Ci ty Job Number J) '\
Dale' ~ -- t ~ - '1 ~ 3. COMPLETE FEE SCHEDULE BELOV
LOCATION OF INSTALLATI~N'f ' d S"gnature ct.~
, u onze ..;I
S-/3~ 'De:i.1 S'7" ~. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
.}
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
l Pjrt3~~N O(fdLf
Items
Cost
Sum
JOB DESCRIPTION
L(pc..! Vt:>/I---;r 5e c.r..-~:./.y <>'-1' <tL:C-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
, Modular Dvelling
Service or Feeder
$ 85.00
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
$ 15.00
$ ~O.OO
Electrical Contractor
A t::>T
B. Services or Feeders.
Installation, Alterations or
Relocation:
2. CONTRACTOR INSTALLATION ONLY
,Address (S-~(
7>~c...r-1 SJ.
.)'
Supervisor License Number
,&5" L-~U.:
200 amps or less
201 amps to ~OO 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
Ci ty C- l.;"" tJ "-...Q.....
"
Phone '3. Yl -/ j ()
Expiration Date
10 - >0 - 9~
,ConstrContr. Number S-e:z''-f'-f,
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
~ - Z- '7 - '1>
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ BO.OO
volts see "B"
above
Signature of Supervising Electrician
'r2j)-<f~
Ovners Name D'A '" e/h.. A r- tv,>y
Address S4-~
, -
D. Branch Circuits
Nev, Alteration or Extension Per Panel
OVNER INSTALLATION
One Ci.rcui t
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00.
Ci ty Phone 7'1/-<gc;:>S""'3
$ 2.00
The installation is being made on
property Iovn vhich is not intended
for sale, lease or rent.
~~~~-~~:~Li~";-------~---~
RECEIVED By:~k.LO' ~
'--" ,
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
~mitedEnergy/~ _~ $ 20.00
-rimited ~nergy/Comm S 36.00
5. SUBTOTAL OF ABOVE r)(J. DO
5% State Surcharge Ir UO
TOTAL 0/ I, OU
~'
i'
. " ",:'
. . ,
Ovners Signature: