HomeMy WebLinkAboutPermit Electrical 1993-6-11
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-""~;ltcd hao thc~o"ELEcTR.rCAL P'ERMIT APPLICATION
ojflc lane" 11"'"'/ 1')1\ !'<71
City Job Number V\~~;- I
.
225 FrITH STREET t 'I' ElP"
SPRINGFIELD, OREGON 97477 ~~"
, ,
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759 Date_tLf1/t;I, S~::1>
A ,~~- 3. COMPLETE FEE SCHEDULE BELOIl
1. LOCATION OF INSTALL:WfON>d 'gnalure 0...,-
'2-z..-z.o LJ)('J.t"""'Df-, h'. -tr'~A:--'-New-Residential-Single or
00 Multi-Family per dwelling unit.
~~~~: f)'J-<6J ., Service Included: Items Cost
('JOB DESCJU;PTION I J"T;<,bl
-tCLiYn I l!--l r&o/n G.ctJ, f (0(1
Permits are nohLtransferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
. - ~-' .
2. CONTRACTOR INSTALLATION ONLY
Ele~trical Contractor Palmer/Philips
Address 3170 Meadow Lane
City 'Eugene
Phone 688-6121,
Supervisor License Number. ?71 qS
. Expiration Date 1\li~ \C). \ C\S
Constr Contr.Number ~ ,~~ C.
Expiration Date ~. c\, \ q (~'5.
Signature of ~rv.isi,ng Electrician
( fll
,
- ~atlhan t'hH~ps D.
Owners Name p\~ /2., ~5 ~'A ,IA)_
Address 2..2--2.0 1. "GIJ.
City sn-U)Phone fJU,-'5~Cj'3.
OVNER- IJ'TALLATION
The installation is being made on
property'I own which is not intended,
for sale, lease or rent.
Owners Signature:
~~;~~-----------~-tcJ~-\~-~ -i)------
RECEIPT i: \. V ullY~
RECEIVED BY: r 1"\ I ''C^-...-
~ \,'-,
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
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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 volts
$ 40.00
$ 55.00
$ 80.00
see "BIl
above
Branch Circpl h
Po< P~
35.00 .~o~
,,-
or Extension
One !;f.rcui t
- h Additio~
Circuit or with Service
or Feeder Permi t
_L $
$
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
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
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