HomeMy WebLinkAboutPermit Electrical 1991-8-19
, ~- -,--
225 FIFT8 STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769 City Job Number 9' /C>5$t?
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
~~(? (.~~fLdY~.v
LEGAL DESCRIPTION
17-&>3.'27-2 C/. e:;:J 7~C>
3. COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
, Installation, Alterations or
Electrical Con~ractor jlFCllu'1<!--~~~7'. Relocation: ,
_Address s5'5" IA/Es7"" '2.4"'"~ 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
JOB DESCRIPTION
_PA / =_J? ~ ~rG.S"L7"<. /'t> ~A"~~~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
'180 days.
City CVc.bA/e
Phone. =?~L/- /~c>
Supervisor License Number ?7<7i5- :5
Expiration Date
/~-'7 /
Constr Contr. Number ~.:?~~
63:/37
Expiration Date 1~-7/' /? -<3 /'
signa~e ,of Supervising Electrician
1 pI;A. W ~ i'fS S
i'
Owners Name
Address
City Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Items
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
$ 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
volts
$ 40.00
$ 55.00
$ 80.00
see fiB"
above
New, Alteration or Extension Per, Panel,
One Circui t /
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00 7S:c:.p
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
Owners Signature:
DATE:
""""IH.PT Ii:
RECEIVED, BY:
&-/9- '7/
7/~;;o~
/""7 ...._ ~
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5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
-=? 5::. <> C>
j,7S
?Ji:9.75