HomeMy WebLinkAboutPermit Electrical 1991-4-10
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
" INSPEcrION REQUEST: " 726-3769
, 'OFFICE: 726-3759
1. LOCATION OF INSTALLATION 1\ ..
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LEGAL DEScRIPTION
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JOB D,ScRIW,01 ON (
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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. CONTRAcrOR INSTALLATION ,ONLY
Ele~trical contractor~
Address ~~~ ,UJ . ~ Uq;..' ,
, '
ci ty Ii <.i..~~ ~ Phone 34'-1- Jr;:oD
Supervisor License Number, q 'f ~- S
Expiration Date. t 0- '1),
Constr Contr. Number ~ 0 - ':2. go c
, Expiration Difte
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'vauOA INSTALLATION
Name
Address
City
Phone
The installation is being made on
property I own which is not intended
.. for sale, lease or ren t.
Owners Signature:
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DATE: 4 . \f'> " -'
RECEIPT I: 1...1 I q I ( ) "
RECEIVED BY: ~-=-J,lJ. '0. ) ,
ELECTRICAL PERH!T APPLICATION'
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Ci ty ,Job Number
3. . COMPLETE ~EE SCBBDIJl.B BBLOV
A. New Residential-Single. or
Multi-Family per dwelling unit.
Service Included: '
, Items
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1500 sq.ft. or less
Each additional 500 .
sq. ft or portion:
thereof
E~ch Kanuf'd Home or
Kodular Dwelling 1 '70',
Service, or Feeder, " oJ-' $ 35.00
B. 'Services or Feeders (10 Branch Circu1.ts
included). Installation, Alterations
or Relocation:
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'
$ 35.00
$ 60,00
$ 80;00
$130;00
$300.00
$ 35.00
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C. Temporary Services,or Feeders 0
, Installation, :Alteration or R~l~cation
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200 amps'or less
201 amps to 400 amps
Over 401 to 600 amps'
Over 600 amps or, 1000 volts
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$ 35.00
$ 40.00
$ 80.00
see, "B"
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above
D. BraCUitS ' '
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Ne; ,eration or Extension'Per Panel
One Circuit "
Two to ten Circuits
Each Mdt'l ten ,or"
po~tion thereof '
.
$ 35,00
$ 50.P9,
$ 15.00
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E. H'iscellaneous (Service/feeder not include,
-Each installation '
Pump or 'irrigation
'Sign/Outline Lightin~
,Signal ',Circui t or', " '
limited 'energy panel
, 5;
SUBTOTAL OF ABOVE
5% State Surcharge,
TOTAL '
$ 36.,00
$ 36.00
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$ 36.00 ._
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