HomeMy WebLinkAboutPermit Electrical 1992-10-9
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Zo:,lng_. . IU ELECTRICAL PERMIT APPLICATION
9774n_6.~' I t\.,.C{'Z-. A n I 'JA J,
iC~.sro~. I I \ City Job Number ~ ~ ~
Autllorlzod Slgna\UrD~
3. COMPLETE PEE SCHEDULE BELOV
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. .rl)oq~~OF~_)
(~?)~~ n~(oro
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cos t
Sum
f{i) DESCRT~NIlWY1 ~ /)IIjfLlOOO sq.ft. or less
f\o 1 U't(JlllO .UXA . Each additional 500
- . , sq. ft or portion
Permits are nolltransferable and expi thereof
if work is not statted wi thin 180 days Each Manu!' d Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
2. CONTRACTOR INSTALLATION ONLY
Electrical Contrac,tor ~ AB'.::n2/t6 &.
Address Po 13,rv '''?:rJ /
Ci ty ECF1-1!J<A
Phone 1'7, c, -c;- LJO
Supervisor License Number 3 Y (, z -.5
Expiration Date
/O-f~ "15
Constr Contr. Number he., '7 ? 'J
Expiration Date
r;.,-cf-<J3
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~;~~------;:--~i7---,r:t-<:f~ZJ'~----
RECEIPT I: ~.. O'-V-\'.:-:,
RECEIVED B~ <;, /. )
-~)
I
.Q
$ 85.00
S 15.00
$ 40.00 f!t)
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less $ 50.00
20l amps to 400 amps $ 60.00
40l amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C. Temporary Serv~ces 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
D.
Branch Ci rcuits
Signature of Supervising Electrician
IJ~LU\+ .,{~ {!,,,}--/
Owners Nani~.Qll ~.
AddressJfl~ ( I ) {AfD ..~ -
City Pi. JCtlJli .p~one_~c).-ifl!jm
OVNER I'.iTALLATION -
$ 40.00
$ 55.00
$ 80.00
see "nil. above
New, 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 with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
PD.CO
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