HomeMy WebLinkAboutPermit Electrical 1994-7-18
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225 FIFTH STREET ;1 ;Ljt
SpRINGFIELD, OREGON 9747'OtAe ']-1
INSPECTION REQUEST: 726-376~SlgnllIura )J M-
OFFICE: 726-3759 A~hc
ELECTRICAL PERMIT APPLICATION
':;~'Y Job Number G\'\-\ Cf:\...S
COHPLETE FEE SCHEDULE BELOV
3.
1. LOCATION OF INSTALLATION
~ :<:J. 7 ~))7U. J ~. A.
'~GAL DESCRIPTION l~o2CXoCOa:ACO
~-r JJ J - HA::..,9l>RoA) ~~r
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New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Cost Sum
$ 85.00 55
$ 15.00 3D
$ 40.00
Items
\
c9-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dwelling
Service or Feeder
Permits are non-traftsferable 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~$'" I='l~;r.
Address Id. Su) ?-,rp 6t.
Services or Feeders
Installation, Alterations
or Relocation:
B.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 ampsJvolts
Reconnect Only
City MArip""
Phone 415-;) \3,'1
IObIoS
Supervisor Licen~e Number
Expiration Date In-\-qS-
Constr Contr, Number foR7<../~
Temporary Services or'Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
see "Bit
q-~~q4
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u volts
Expiration Date
.
Signature of Supervising Electrician
t?/k~ / ~'-rf4~----
, Owners Na~~~~dQN
Address ~ ~ 3QM
City %..W ~ Phone --AA'l~
OVNER iN~LATION
above
D. Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
$ 2.00
E. Miscellaneous (ServiceJfeeder not included)
-Each installation
Pump or irrigation $ 40.00
SignJOutline Lighting $ 40.00
Limited EnergyJRes $ 20.00
Limited EnergyJComm $ 36.00
5 SUBTOTAL OF ABOVE \ \ ~ Cf:J
. 5% State Surc~rge h.' /='l
l{9TM:. 3~A:J :!. .~"
la4 . iZJ
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
:~~~-:~~--l\.\\~- -!\C\lfzr------\~1-~~~i,
RECEIVED BY: \~ ....,.-