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HomeMy WebLinkAboutPermit Electrical 1993-2-16 ~.-""".",",."a,;,....... . 'T""~ ~::'''~..'!Irf~ "'''o:.j'''ct rc cubrnitl-::J h:-'" ~ho ro.lvwfi1g ~, 225 FIFTH STREET h"~, and :1000 nol rOGu;,. "~J:;;;c !w:l UCJ ELECTRICAL P'ERMIT APPLICATION SPRINGFIELD, OREGON 9i'47rl. ~ I (). 7?0 INSPECTION REQUEST: 726-3769n2_\ (...., _ Ci ty Job Number Q';;/3o 7 OFFICE: 726-3759 Date__~lJ-9) 1. LOCATION 01'JNSTAllFJitTiON Signature S r 3. .~O tv. ~AJ/i?)JIEk) A. COMPLETE FEE SCHEDULE BELOV New Residential-Single or Multi-Family per dwelling Service Included: uni t. 10 '[ij~DPjlfy'rr~ I () I tA-A/E' ceJ. #eu5I#6, JOB DESCRIPTION RE"rIOL. i!Ja>~ ,oPB/€R. Items Cost Sum $ 85.00 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder 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 B. Electrical contractor_JS<.JtJ~Y' I::<B:T- Address PO 15 ;;'/503 Ci ty ,?;;;Ur:;, 97t,h;;;L Phone t,~- ;;13(;,5 Supervisor Lic~nse Number 3:;Jf~ S $ 15.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: $ 50~00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 200 amps or less, 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only Expiration Date Ib-/~~~ Constr Contr. Number 'frIaS''$? Expiration Date (,~'J.7-1~ Sigr9~ 9jctrician W?/J ~/ Owners Name I-fA (!So/ Addressd 00 W . !::::h; At )( 'au ') City ?i'((cL Ph~ne lofs'f}-1{ffO OVN~ I~STALLATION Temporary Services or Feeders Installation, Alteration or Relocation C. $ 40.00 $ 55.00 $ 80.00 volts see "B" 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 above Branch Circuits D. New, Alteration or Extension Per Panel $ 35.00 One Circui t Each Additional Circuit or with Service or Feeder Permit $ 2.00 The 'installation is being made on property I own which is not intended for sale, lease or rent. E. Miscellaneous (Service/feeder not included) -Each installation Pump ,or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limi ted Energy/Comm --'-- $ 36.00 3(, 'd!E!.. 5. SUBTOTAL OF ABOVE .31..~ 5% State Surcharge lSo TOTAL ~,~7.80 Owners Signature: ~A~;~-------~:~~-~~----------- RECEIPT I: ,J I }~;l?\ RECEIVED ny:. i=s. r 110 / 0'\- -