HomeMy WebLinkAboutPermit Electrical 1993-1-22
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225 FIFTH ST\U!BT The. following project a9 .~bmltled has the foll45lllltTRICAL PERMIT APPLICATj ~ ,:1 '
SPRINGFIELD OREGON 971i!lng, and does not require specific land usa . q '2J~' \\ J-S .
, roval.
INSPECrION REQUESTI 72 -3769. I , '" "I) City Job Number ~ ~
OFFICE: 726-3759 Zoning h <LJI\C-
Dat. 11 b? 1131~ ~l- CO~PLETE FEE SCHEDULE BELOV
1. LOCATIQ.NOF INSTALlATION 0 - '1',3 ,
0\503 Du'WlA-'5---P;Uthcrizedsignature "c.:, J.. Ii... ;h;..lJ..ntlal-Slngle or '
Hultl~Famlly per dwelling unit.
Service Includedl
\~~~~f~~ON rf)\Lq
.JOB DESCRIPT,ION L
WLlU" PA-tvlU1 'f2.Dr.lVV\~ u~th Il-flnlTlOrj
.Permits are non-transferable and eXPir~:?:7.31
If work Is not started within 180 days
of issuance or if work is suspended for
'180 days.
2. 'CONTRAClOR INSTALLATION ONLY
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
. Hodular Dwelling
Service or Feeder
. Electrical Contractor L.R. BRABHM1, INC.
B. Services or Feeders
Installation, Alterations or
Relocation:
Address 68 W. "Q". SL,
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
City SPFLD
Phone 747-6638,
Supervisor License Number 14735
Expiration Date 10/1/95
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
08699
loW18/93 '
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $'80.00
Over 600 amps or 1000 volts see "B" above
Expiration Date
x
SI!"a~e ~f Supervising Electrician
,7.,-... ~ A JL
Ow~ers ~elM~'\-tH:iyJ;~'Ie"bUt.hIID.
Address~03 DtN>>1~
Ci ty t; otGD
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit (
Branch Ci rcui ts
New, Alteration or Extension Per Panel .
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Phone
I .
OlINER INSTALLATION
The installation. is being made on
property I own which Is not intended
for sale, lease or rent.
Owners Signature:
. ~ATE: - u'~:-{1()..fu . ~~~\
RECEx'ri I: -':::JjitJ ')\
RECEIVED BY: (. .
\J'f
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$,35.00 35.CO
$ 2.00 ~ ,00
$ 40.00
$ 40.00
$ 20.00
S 36.00
37.00
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