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HomeMy WebLinkAboutPermit Electrical 1991-2-26 225 r~r.n ~.AL6. 'SPRlNGFlELD, OREGON 97417 . .INSPECTION REQUEST: .726-3769 OFFICE: . '726-3759 1. U)~O,NO~STALLATION (\. ~ \ \ _" n XY\ 0....1(\(7.:. LEGAL DESCRIPTION "llt~~ON " permit~re non-transf~rable 'and ~xpire if work is not started within 180 days of issuance or if work is suspended for 180 days, 2, CONTRAClOR INSTALLATION ONLY B. Electrical Contr,actor1l00m)}~ . Address.!E....f)(\~ -D.liL! ~('J1 &9-. Ci ty C\. c; r(\ Ve~ Ph~Qe q4~ -S If,J 72- . Supervisor License Number c!)f}()R S 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 Expiration Date /o.q / Constr Co~tr. Number 3 81<.2) /) Expiration Date A If) / q . I I Sign.~. e'of supervising. Electrician \. ~.....~ ~. \\ \\SJ ~1' ~ . . '.' - . .t.(Q....h0......~_.d_ 0... _J.l_I!., Branch Circuits . Owners Nam~l..\'l ~llmr\1~l M.LlQ.(~ . ...... 'I'\/Iq~ rYl." fl..?\l;~' New, Alteration or'Extension Per Panel Address,..:.....JVj ., \ .10 .J.L I " . . ..... e:;:'-' ':.'. ...-1("/, 317'//'\ OneCircuit. $35.00 City' (~P~l1 n; Phone ~I.. )-'- _ V. .Two ,to ten Circuits" $ 50,00 . . .' Each Addt'l ten or .OVNER IN ALLATION' portion thereof $ '15.00 The.installation is being. made on property I own which is .not.intended . for sale, lease or rent, OWners Signature: DATE: . RECEIPT I: RECEIVED DY: a?~Co.<4 ( ~~~ C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 35,00 201 amps to 400 amps. $ 40.00 Over 401 to 600 amps $ 80,00 Over 600 amps or 1000 volts see "B" above E~ Miscellaneous (Service/feeder not included)' -Each 'installation Pump or irrigation.- Sign/Outline Lightin~ . Signal. Circui t or limited. energy. panel' 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $36.00 $ 36.00 $ 36,00 1m ,a:; '7.01.../ I ()~ (I()