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HomeMy WebLinkAboutPermit Electrical 1992-4-10 SI"IIINt;t:'ICLU ~..~ ~" 225 FIITH STREET n:&:~":)';'nlol l-\'o't'C\ ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ,~Z~~~~" :,,,j ooo/no: ~~q~~~am:n6::l. hn~ th~ IO~QWlllll ' . INSPECTION REQUEST: 726-3769 o. SpeClfio~'~ty Jbb Number q7e:::>~~ OFFICE: 726-3759 AZCY" . Da!t' ~ ' PLETE FEE SCHEDULE BELOV 1. LOCATION OF INSTAL~, ON y-- ....:.. /' /.::>'"7 #' ~.c( '7 c: 'S/9flelure New Residential-Single or , ~i-Family per dwelling unit. LEGAL DESCRIPTION Service InCluded: //-.t?3-:~Y-/Y P'P-;?e::rC:> Items Cost Sum JOB DESCRIPTION , .e::::-. W/7ft= _<\. ~~~ ........~ 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 Address City Phone Supervisor License Number Expiration Date 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 $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Constr Contr. Number C. Temporary Services or 'Feeders Installation, Alteration or Relocation Expiration Date Signature of Supervising Electrician . ,D. Owners 'Name , 7fh.4~ 7?~ ~~7~~ Address 6.0.2 ~~&:..Lr?!S-vZ? Ci ty 0;.P~Z:> Phone? 7"6 Y':>"7;> OIINER INSTALLATION The 'installation is being made on property I own which is not intended for sale. lease or rent. Owners Signature: DATE: l.{- ~(O -1 z..-. RECEIPT #: YL..-'t1 RECEIVED BY: IN\/'- " 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Branch Circuits $ 40.00 $ 55.00 $ 80.00 volts see "B" above New, Alteration or Extension Per Panel , c...----- $ 35.00 "'A=..- ~ One CirCUIt ~~- Each Addi tiona1 Circuit or with Service or Feeder P,ermit. / $ 2.00 2.. no t i neluded) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lightini Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ $ $ $ ~'~ I~S '959. ~;2 40.00 40.00 20.00 36.00