HomeMy WebLinkAboutPermit Electrical 1992-1-31
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~ _ r.)",r,\\tOO ,;;~-d~~ECTRlCAL PERMIT APPLICATION
97477 _--io,,' ,,<" '.." .'-0'.',' q rrA I
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726-37q~~,I\~~,~e1"\ """",,, oW Ci ty Job Number . {:j
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tor.ir.'1-~HPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION (~~Ir _ '(...1..1 ~ '
'?b'l$O ~ AS\'C>c'17- 'ot\';>-~,sdl~\v-1{esidential-Single or
\l:,(J!....Y' )LOI'..J LY\-"1~I.."..--- Hulti-Family per dwelling unit.
tt'C'At1nfSCRIl>t1\:lN Se rv ice I nc1 ud ed :
Pew<</....., !.:""r-,k..... E' /......-., S """"'" I
.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
JOB DESCRIPTION '
Lo"-,V,,Ih. ~......ok.. D..I-rc L..... do ~~......:-u:. 6" ,
...~y>~ ..j.... ~~',hl AI~~- (;.._.f,....1
,Permits are non-transferable and expire
if vork is not started within 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ""DT
Address 1 5"01 ?~A(2.L
City /?Ub/;-N~
Phone .....'11.--1'3/'1
.
Supervisor License Number ?S L ~ L ~
Expiration Date
lo-I-"}')
__ ~5!'IIING.r:IL:LU
Items
1000 sq.ft. or less'
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Modular Dwelling
Service or Feeder
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
,--
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number ~q'7'1t...-f
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Y-Z'1-"i't..
Signature of Supervising Electrician
~JJ~~~
Ovners Narrie S"",',~J.'.A~ S~".,1 ,D,~I
Address S"2, M;,I sl.
City >Vl....:;,J..:.tJ Phone n{,- '15S<g
OIl'NER INSTALLATION
,
"
: I
The installation is being made on
property I own which is not intended
for sale, lease or rent.
.
Owners Signature:
----------7--------"77";- ----------
:~~~PT #:'. -'1~~~'1 '
RECEIVED BY: ~~~
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 "BU
above
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$
$
$
K $
81oLJO
3">: ~~
40.00
40.00
20.00
36.00