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HomeMy WebLinkAboutPermit Electrical 1992-6-25 d has the lollOWing "'.i.", rolect ee submltte lfic land uce ~... The lolloWlnd~~e. not requlro spee ELECTRICAL PERMIT APPLICATION ~9ojng, en 9/4>~il)val. e... 726-37!~lng_ \AD 1,1;)-\ 1'lJ Ooto__ 12)6 LOCATION OF INSTAL~~ Silln;>ture_ 47 /cCHt5?7<2fJ/' . I 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. LEGAL DESCRIPTION /~:r. 02... 3 " n~7bn JOB DESCRIPTION /1/.N. /,,'bV~ Permits are non-transferable and expire if vork is not started vithin 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 Constr Contr. Number Expiration Date Signature of Supervising Electrician OvnE;!rs Name PHy 4c", E'//,':: Address J/}~ mer ~ 11-- L Ci ty :5i'f71 Phone 7U -~5'()1 OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease ?r rent. ovn~ Signatu~~: ,~/Z_. -----~------------------~-------------- DATE: RECEIPT #: RECEIVED BY: -,A.S"/,..z..:. ,"r ".-' ? , " '~.:z.7L ~~ ... SI"'IINct:IELU City Job Number 9 2c:) ~ <;; c:; 3. COIIP1J~'1''' FEE SCHEDULE BELOV A. New Residential-Single or lIulti-Family per dwelling uni t. Service Included: Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dvelling \ 40 Service or Feeder $ 40.00 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services 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 $ 40.00 $ 55.00 $ 80.00 volts see "B" above D. Branch Circuits New, Alteration or Extension Per Panel One Ci.rcu it Each Addi tional Circuit or vith Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm no t included) 5. $ 40.00 $ 40.00 $ 20.00 $ 36.00 #J"t!J . .2 "'0 -f'? ~ SUBTOTAL OF ABOVE 5% State Surcharge TOTAL