HomeMy WebLinkAboutPermit Electrical 1992-9-21
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225 FIFTH STREET <:o;':'Ol!olVi"g;lI'ojl>ctELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Dppr~f.~~n<J do", 110~ ~:qSIJ~~ml!ted has the f /I ," q (\ y\ <7 ()
INSPECTION REQUEST: 726-3769., speCJfJC/~ec:mI'PNumber rll )(,)D
OFFICE: 726-3759 ~orlr"o LOe.
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1. LOCATION OF INSTALLATION",,;,-i>, '7~
4.. 'S ;Z -3 F., /l<,7t. , . _ ~ OCi SlllJla/lIre
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JOB DESCRIPTION ../ I ()Qn r1
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Permits are non-transferable and expire
if work is not started ~ithin 180 days
of issuance or if ~ork is suspended for
180 days.
2. CONTRActOR iNSTALLATION ONLY B.
Electrical Contracto~4f('" i> E~",r ..z;;r
Address' ~8 '7t:?D' J1::i&vu I... iii.
City ~"'AJ..(,";'I.f Phone 7~-'9~?
a.J
Supervisor License Number 3~-;>
Expiration Date ([) . \ . C\l-
Constr Contr. Number ~~~
Expiration Date 4- 1_. q~
Signature of
v~~
o~ner~rrie
'--/
Supervising Electrician
0/
<; -ra: '" e
tln.wSI?Y
Address <
City Phone
OYNER INSTALLATION
The 'installation is being made on
property I o~n ~hich is not intended
for sale, lease or rent.
Owners Signature:
~A~;~-----------~--~~r~-::-
RECEIPT II: Lii , lV'\.ul .P:):.."")\)
RECEIVED nYG~l,,," ~~J ' ,
€Q~Pl.RTE PEE SCHEDULE BELOY
Ne~ Residential-Single or
mily per d~elling
Service Inc ed"
Items
1000 sq.ft. or less
Each addltional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular D~elling
Service 'or Feeder
Services or Feeders
Insta~lation, Alterations or
Reloca'ti?n: '
200 amps or les's ,
, 201 amps to ,400 amps
401 amps to 600 'amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
uni t.
Cost
, Sum
I
$ 85.00 85,0-<>
$
$ 15.00 ,,-?,(J. '" ..
$ 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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see liB"
above
Ne~, Alteration or Extension Per Panel
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Ci.rcui t
Each Additional
Circuit or ~ith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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