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HomeMy WebLinkAboutPermit Electrical 1993-6-11 SI'11INCI""Il.;LO ~ -""~;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 ~s,oo j,I<-'- '2./. -:Js