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