HomeMy WebLinkAboutPermit Electrical 1992-12-11
Th~ bHowing project as submitted has the follovli' tt'f
'ung and docs not require cpecific land use . ~
225 FIFTII STRlmT _ppro~al. ELECTRICAL PEIUlLT APPLICATION
SPIUNGFIELD, OREGON 97/,77 L Dt< qf\ II ,..10.
INSPECTION REQUEST: 726-3769 Zonina...... Ci ty Job Number ri LVI{)
OFFICE: 726-3759 Date l'd..- \l{-'7a..
h ' d S' lure 3.l))COMPLETE PEE SCnEDULE DELOV
1. IA,CATION 0J'b IN~TALLA;I'IOIl. ~t onze 'gna '
(()/I ('OLO LA '01-\) A. New Residential-Single or
, ,- - 0 Mu1 t i-Family per dwelling uni t.
\ <t:'E)!:fLMltN ~ Service Included: Items ~ost
-Tj
SJ,(m D~IPTION - ll.o (8-
\- '\;:-10 [) ~ k,:<J f'f\ r
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. CO"",^CTOR INSTA~~N ONLl
Electrical Contracto" If(\n~
Addms ~() ~'-i.. ~ -
- ".~ '
Cityfh u6vr rhone~ces
Supervisor License Number ~~c::)0S
\b. \ .Cf6
;:) '?1\ () I
f(). S .q-?J
Expiration Date
Constr Contr, Number
Expiration Date
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~;~-~--~):)~-rl~-~~---~----------
Rr:Cr:II'~ #: - r J . , rrDD-\
ItLCUVW IlY:n~_.n___._'_.._.
~"IIU..(.;.I:'t;.LU
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof'
Each Manuf'd lIome or
Modular Dwelling
Service or Feeder
--L
A
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
An
3D
$ 15.00
$ /,0.00
-,
$ 50,00
$ 60.00
$100,00
$130.00
$300.00
$ 40,00
Temporary Services or Feeders
Ins~a11ation, Alteration or Relocation
to
C.
One Ci.rcui t
Each Addit ional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
rump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
200 amps or less
201 amps to 400 amps
Signature of Supervising Electrician Over 401 to 600 amps
:::r(\') \ I , Over 600 amps or 1000 vol ts
1"' VV\_...:'\C^^ -R-.
Owners N illG J\ JY1 Jt! _ ~I1.d.o A.:J Branch Ci rcui ts
~I _ rI\ A ",.tl:-~ New, Alteration or Extension Per Panel
Address \.' jU\"o '--l' I \\ f" "-
City 5;Df:in J rhone:JJ&5~qCJ
OVNF~ INSTALLATION
5.
SUBTOTAL OF ADOVE
5% State Surcharge
TOTAL
(
$ 40.00
$ 55.00
$ 80.00
see "nil
above
$ 35,00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36,00
Iffi aJ
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