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HomeMy WebLinkAboutPermit Electrical 1991-1-10 SpnlNGFIELD ,. 225 FIfTH STRKRT 'SPRINGFIBLD, OREGON 97477 ,INSPBCTION REQUEST: .726-3769. OFFICE: .726-3759 '1., I.QCATWN'py IN~~TION. .. J-;;~~)O() ..L4{):::l,.~ IN Cr!1::t -" .' ',,' (dJ}1~a;m!J6r eo~ Permits are ~-transferableand 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 -c:;ity . Phone . Supervisor License Number Expiration Date . Constr Contr. Number I I, I ,Expiration Date Signature:of Supervising.Blectrician x..:' . Owners Nam~ .tfruf\! . . ... Address cOR["(~~\Q\ I~ ..City .'P:JU.U\..L.Phone ~'1?15~. () . . . OVNER INSTALLATION , BLECTRICAL PERIIIT APPLICATION City Job. Number . q{)/()~O 3. COMPLETB FBB SCDBDULB BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1500 sq,ft. or less $~ Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 35.00 B. Services or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: Temporary Services or Feeders Installation, Alteration' or Relocation $ ~~.~ lro~ $ 40.00 $ 80.00 volts see "B" above 100 amps or less. 101 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only C. 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps. amps or 1000 Branch Circuits The installation ,is being. made on property. I .ownwhich is not intended for sale, lease or rent. Owners Signature:' ,!)~ '^"'.... J)bwJXf~ ~- - --~-----J-----~ .. DATE: {-/{..rq . . RECEIPT I: I 9 ~ RECEIVED BY: I D<1\~_ $ 35.00 $ 60.00 $ 90.00 $130.00 $300.00 $ 35.00 New, Alteration or Extension Per Panel One Circuit . . Two. to ten Circuits Each Addt'l ten or portion thereof $ 35.00 $ 50.00 $ 15.00 E; Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Signal Ci rcui t or . limi ted energy panel no t included) $ 36.00 $ 36.00 $ 36.00 ! r~' (JJ . -ri;:'~ ~ 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL eCk.~\'\f'l\~Jj~