HomeMy WebLinkAboutPermit Electrical 1992-1-9
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225 FIFTH STREET ""'5'lI."\'!-~~1i,~'\iELEciRJ:CAL P'ERMIT APPLICATION
. SPRINGFIELD, OREGON 97477 ~~~;;'::'$"'''' fPf'lDO(!
INSPECTION REQUEST: 726-3769,~t~d'~~ lty Job Number ~\CX
OFFICE: 726-3759 ~o;~~~i:t. .-
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c. MJQllI DES~PTION .n....n:.............
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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. CONTRACTQR INSTALLATION ONLY
Electrical Contractor
Address
Ci ty
Phone.
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
I
Ololners Narri~~ ~/~r
Address,;}-/t::)[) IAUutL~, ::II:A'1
City ~,vl . Phone.:51-/<;;-4t:;7t
---'-"Ff)- (CJw.< la. w-r>-t)
OI/NER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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RECEIPT I: ~l-fkV
RECEIVED BY:J\H DIl/M-t.
bULE BELOI/
esidential-Single or
Multi-Family per dwelling
Service Included:
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
uni to
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00 4D
$ 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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above
Nev, 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
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