HomeMy WebLinkAboutPermit Electrical 1998-3-25
1Ml0' y I 3"~"1C
zoning. and doco not roqu ro ' VV-'
app~rovl. .V
ZonlnQ.
[)ale '
, ,__,GUY\ ;ll.ECTRICAL PERMIT APPLICATION
9~".1' ;... J :W\lti't;;o _' E lFiHE WUl'I" if O~ O?
726-3769 SI"ERtJI\I S\-l~LLE)(I"IR c:PMr\g~iNumber qf) 0 .~ 7-....':)
,IHI l\loER 1\-11S 1".. "
~llIHORIIED ll':r; &~llliQrlBERSCHEDULE BELOV
1. LOCATION OF INSTALLATIOrt ENCEO OR IS 1'1
CiI"1'l.. 0 'I!:) N\Q(\)of' COtJItJI _ ~'/I"~R\Oijf'!W Residen tial-Single or
- ~N'/ l11V Y, Mul ti-Family per dvelling uni t.
JGAj'D~~eR.IfrJO 2/1 ',Service Included: 'Items ,Cost
225 FIFTH STREET
SPRINGFIELD, .oREGON
INSPECTION REQUEST:
OFFICE: 726-3759
JOB DESCRIPTIO~~ '
(:::::,. \ D" """ 'S".s
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 INSTAg.ATI9tl ONLY
.,;.- c.C),"(". -\-~ ""Ill? ~~'''''
Electrical ContractODr ~~\or\-'~
Address 'V, () , \.J,-:-,--.,::- n(!,. \\ '1..,
Cit,g::;(),L.,D~~ Phone (,...,<;()..-U-iJL\
~0l-~
Supervisor License Number (l.:l -1.-\ l/ <.U2.
Expiration Date_ \'0 101 l"'l~
Constr Contr. Number \~ c;b, (r-"2..,
Expiration Date \2>/ \'"'1, \~"1
Signature of Supervising Electrician
Iv. ~ \J.-.-1-'
o:ners Name c,>JL~'("' wr-:,\(..t. ~ D. '
Address (~<: <\~,
Cit~,\\<.f>01.., Phon~\'C;::~(...,1
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
, for sale, lease or rent.
Owners Signature:
DATE~-~-~-l~Jft1~----~---~~-----~--
RECEIPT II! " ()}.-'1,LU)<,
RECEIVED BY: 'X' fyJ j..A-/"-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
,B.
Services or Feeders
Installation, Alterations
or Relocation:
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
Sum
$ 85.00
$ 15.00
$ 40.00
$ 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 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
.'
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permi t ,$ 2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
(t.
$ 40.00
$ 40.00
$ 20.00 diHlO
$ 36.00
.20. 0 0
/' UU
, -' i f...D..
L/. /.fO