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HomeMy WebLinkAboutPermit Electrical 1992-9-21 . ~~ ~ ~- ~ 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. 1).'1,...:!.L::1I/.1. 1. LOCATION OF INSTALLATION",,;,-i>, '7~ 4.. 'S ;Z -3 F., /l<,7t. , . _ ~ OCi SlllJla/lIre \~~1Q>W;t~NO \QW JOB DESCRIPTION ../ I ()Qn r1 U:J'M tJ/.u..L> '~;~....L.ua.1 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 l{~.oO _ ,,~.' ~>'- I~ln, c:- ~- -~