HomeMy WebLinkAboutPermit Electrical 1992-1-9
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225 FIITH STREET #!~~~ ELECTRICAL PERIlIT APPLICATION
SPRINGFIELD, OREGON 97477 ~~",'lD-'
INSPECTION REQUEST: 726-3769.~~" n)
OFFICE: 726-3759 <>lIIW~'d \:!..?
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1. LOCATION OF INSTALLA~O'N ~ot-~
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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 (
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Supervisor License Number ~;7~~
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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
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