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HomeMy WebLinkAboutPermit Electrical 1992-1-9 . <m~ ." ..~;!ty,~l> . tt, 225 FIITH STREET #!~~~ ELECTRICAL PERIlIT APPLICATION SPRINGFIELD, OREGON 97477 ~~",'lD-' INSPECTION REQUEST: 726-3769.~~" n) OFFICE: 726-3759 <>lIIW~'d \:!..? &."="" 3 ~~;~~. . 1. LOCATION OF INSTALLA~O'N ~ot-~ h/96- !s:/1/111i./1 //1/' \')' ~ " K.~' . ~rn DESptl;PTION t~. . ~G \ 'r< (- r4-\4- m lo~"5 ' Co . \JOB jll:SqRIPTIQN -J. . l~l1\(\~" tr) - -- -- 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 f1~e'~~~ Address ..;::y;;/"7r; f!.h&r~ ~ Ci ty ~ -c Phone 17&/'-;;217 ( . ? Supervisor License Number ~;7~~ . Expiration Date ./0-( -72 =>>I'-I'II",,,",'-IK;.LU b Number cU)n~ unit. -b cos~um Items $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Constr Contr. Number ":"2 #_)7' C. Temporary Services or Feeders Installation, Alteration or Relocation FEE SCHEDULE BELOV New Residential-Single or Multi-Family per dwelling 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 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 Expiration Date /.2-/'('-;7.2 200 amps or less , 201 amps to 400 ,amps Signature of Supervising Electrician Over 401 to 600 amps ~ ~?""~ ~ Over 600 amps or 1000 vol ts - ,- - ~"' ~ ,<. I I ." .-:::11.... ....."J!).. Branch Ci rcui ts Olmers Name, 0 ()f)\ U )~ rl .LI' =. " \~ New, Alteration or Extension Per Panel Address '-1 Tt,QY\1T r6}9-- '2. 'C' C a One Circui t I $ 35.00 ~ CitY_T 1 )~' Phone Each Additional Circuit or with Service OVNER IN TALLATION or Feeder Permit S 2.00 The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~;~--~-T--q--C?':J:..~:--~=---~-~---- RECEIPT II: .r -f:::A I\.-?'l ~.:;z;J- RECEIVED BY:~'_j/'~- , Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 40.00 $ 55.00 $ 80.00 see "Bn above not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 -2,S r;x) 1.7e:::.., ..0..1 O.J:::5.