HomeMy WebLinkAboutPermit Electrical 1992-4-2
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225 U.~UI STREET .,;'p;ovaL q. lIfeI8i>ij~LECTRICAL PERHIT APPLICATION '. .....
SPRINGFIELD, OREGON 97477 Zooin.' ... nnr\-:2...& I7d
. .INSPECTION REQUEST: . 72~3769 .. -0 . . City Job. Number' ~\ '/J...JCJ C"l
OFFICE: .726-3759 .. 10.' , :...Ll .
. AuthoriZed Sisnatwroix't 3. COHPLETE PEE SCDEDULB BELOV
1. ~~ O~~~~Kl \ 0'< . A.
LEGAL DESCRIPTION
'~~E~~orct Qi\l\..Q
-'
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
New Residential-Single or
. Hulti-Family per dwelling unit.
Service Included:
Items
Cost
Sum.
laOO sq.ft. or less ~ $ 85.00. ~g.e>.
Each additional 500
sq. ft or portion
thereof ."1 $ 15.00 . ~<!/_ae.
Each.Manuf'd lIome or
Modular Dwelling.
Service or Feeder .$ 35.00
2. CONTRACTOR INSTALLATION ONLY. B. Services or Feeders (10 .Branch' Circuits
.1\ . ,J\ included). Installation, Alterations
Electrical Contractor~\ 00 (\In.J\.V \L,.../ or Relocation: .
Address'1 c:rl D<.:?, \)\) ~" ~ ~~ 100 amps or less ..
Ii r ' ,: (1...1 I) ':l."\ . 101 amps to 400 amps
Ci ty \ ' . l "J'\lJl. R . Phone ~~ '( ) to 1 ~ 401 amps to 600 amps
A 601. amps to 1000 amps
Supervisor License Number C'Jf)_~~ . Over 1000 amps/v~lts
.' .\0. \ ,ql'\ Reconnect Only
Expiration Date r--J.
.Constr Contr. Number 3g~<...~lD
~.;:{ .CO
.Expiration Date
$ 35.00,
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
v $ ~OO '-16
$ 40.00
$ 80.00
see "B" above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps.
Over 600 amps or 1000 volts
.Si~e'of supervi\in.g.E. lectrician
l~. ~ ~.." 0' i
- , . \... U\.: .. -llU.l \......-v-\",.p. Branch Circui ts
Owners Name ""'i\), 1}.1 1\ 0 . _\ .J. T"U\ LUV....k-
Address AqC{~ N\-OtrJt \ \)c:::... New, Alteration or'Extension Per Panel
City. U~. 1\.0 ,.p.ho~e~0\1G . .~~~ ,~~r~~~\ircuits . ~ ~~:gg
Each Addt'l ten or
.OVNBR IN ALLATION portion thereof $ 15.00
The.installation is being. made on
property. I own which is not. intended
. for sale, lease or rent"
Owners Signature:
. DATE: 4. 2. '<-f&~,
.. RECEIPT I:.G{~ I
RECEIVED BY: I
E~ Miscellaneous (Service/feeder
-Each installation
Pump or irrigation:
Sign/Outline Lighting
. Signal Circuit or
limited. energy panel'
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
not included)
$ 36.00
$ 36.00
$ 36.00
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