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HomeMy WebLinkAboutPermit Electrical 1993-4-2 (2) . e SPRINGFIELD , " tlv'l io\\CNli\19 225 FIFTH STREET . r\ ~rc';"'cl 0,': ":liJbt"1"'P:!':'~'::I'~d ,ISi:: SPRINGFIELD, OREGON:h9,~9;t~~,~(-, "\p"''- - ': ,', , INSPECTION REOUEST:zon7'26'::"'3769, OFFICE: 726-3759 a?prvJ~!~ 'r; --'0"-- 1. LOCATION OF INSTALLA;;~~Y' 3. - - O~-~- .- c:G~~"lH..e:~~-"~, r-~{-,,,t\\;e- 1t.. New Residential-Single or ,I" " / ~uthOnzeJ':'.;;. " Mul ti-Family per 'dwelling uni to LEGAL DESCRIPTION Service Included: ~.~~-~~...-- ~ JOB DES~ION '~~~ '4'tF CZ'-:c7"~ Permits are non-transferable and expire if work is not started within 180 days of issuaric~ or if work is suspehd~d for 180 days. 2. CONTRACTOR INSTALLATION ONLY B. " Electrical Contractor~Q~ td..Qr:..?; /~ Address f/;;J- -.3 >-,,;2 ~c../cu-,,-~cr /7C<.-/ City \'P:?/Cr,...C;'p/'tS'L-.i) Phone~~-;r?~ Supervisor License Number /~I 5 Expiration Date /0 -'7:3 .1 ELECTRICAL PERMIT 'APPLICATION Ci ty Job Number 9:503.5'7 COHPLETE FEE SCHEDULE BELOV - Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof' , Each Manuf'd Home or Modular Dwelling Service or'Feeder $ 85,00 $ 15.00 / $ 40.00 &/ d7.'o (/ Services or Feeders Installation, Alterations or Relocation: 200 amps or less 20.1 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 " , Cons t r Con tr. Number ;:po-;; 7...;:z.... Expiration Date /~~? '3 . Signj2e o~s ervising Electrician ,~ ;g; ~~ -- - -~- C/ - - - , Owners Name ~.;er 5~ c.... ~A> , 200'amps or less 20.1 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits ~ V' Address Ci ty, 'Phone , OVNER INSTALLATION The installa~io~ is ~eirtg made on property I own which is not intended for sale, lease or rent. Owners Signature: --------------------------------------- DATE:, ~-~ ~...~;::> ~RECEIPT I: '--? ?~9Z!...- ~ RECEIVED BY: /" /~-., ~ ~" New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.0.0 $ . 2.00 . E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limite~ Energy/CQmm 40.00 40.00 20.00 36.00 not included) 5,.' SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ' $ $ $ $ ~ ".,. -'2 . ..-. ~..L.lP r . , . . ~