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HomeMy WebLinkAboutPermit Electrical 1991-9-3 ~ 225 FIITH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION YiJ4 ~/\P'/' QAt ~rld. LEGAL DESCRIPTION l~ (,);)D<::" j:2.(,) '2.,Jo:2 JOB D~CRIPTION <;(tU'p I (;/"r'vr>o'{.L lAJ~...-..,^~ 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor {)\.lfXJ.jlh, Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name ---:p(i H.o (j~,~/J;1J Address l-..!iJ'-I ~~r~ !)a? 141-301:) Ci ty ~~IJP Phone OIINER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: \~~~ C\A-A-:M --------- ~~L---------- Qh\<'1 I ;::),11 ,I(~ 60(~ DATE: RECEIPT 11: RECEIVED BY: Ci ty Job Number 0) 1 n ?,(') J 3. COMPLETE FEE SCHEDULE BELOV It ems A. New Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 85.00 $ 15.00 $ 40.00 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 $ 50.00 c:;(").oO $ 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 $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Addi t ional Circuit or with Service or Feeder Permit ~ $ 35.00 $ 2.00 / d.cx) E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 40.00 40.00 20.00 36.00 not included) 5. $ $ $ $ (o:f .('Y) -':$./~ InS,j~ SUBTOTAL OF ABOVE 5% State Surcharge TOTAL