HomeMy WebLinkAboutPermit Electrical 1994-2-14
.
..
........ "-..
.",
"
SPRINGFIELD.
,
. ' . . ' eel haG llie ioitow1nd ,.
, ," i ' rolect at llub/n!ll .c~\c land use
225 ,FIFTH STREET 'fhi\~~~:nd9d~. not reC\",lt~ sp ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 974 rovo1.
OFFICE: 726-3759 0 - .
" 19 d- h~ 3. COMPLETR IlHF. SCHEDULE BELOV
1. LOCATION OF INSTALLA~O~lllui"~'
530S? LEor-R ('~?lf.r A. New Residential-Single or
- / Multi-Family per dwelling unit.
Service Included:
/ LEGAL DESCRIPTIO~}A..r>.
71')~~:~ It05~
JOB DESCRIPTION 0"'" 1000 sq. f t. or less
f)uPLE:x :J,c1;J,6ILlIS ,...~) Each additional 500
" ,sq. ft or portion
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
B. Services or Feeders
Installation, Alterations
Electrical Contractor I---Ir;:; F/~.rrKIL or Relocation:
Address Po Ben.). 11139 200.amps or less
201 amps to 400 amps
City E1tr;: Q7iJI/,/) Phone 7.J. 9-09t/ff' ~ 401 amps to 600 amps
, 601 amps to 1000 amps
Supervisor License Number ~~~~'~ Over 1000 amps/volts
,- Reconnect Only
Expiration Date /0 -/-95
Constr Contr. Number '597L/g
2.
CONTRACfOR INSTALLATION ONLY
Expiration Date
- S -if-9';'
Signature-of-Supervising-Electiician
*(. ~~;~.~+tt./ . ~
.. V U...,p'
Owners Name T'\J,' , '
Address
City
Ab:~ ~<{
Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DA~E~----------~--~IJ~I~~~-----------
RECEIPT II: lIi"c;~
RECEIVED BY: I ()~
Items Cost Sum
"'J.- $ 85.00 /7tJ,~
d-. t:iO
$ 15.00 50.=-
$ 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 volts
D. Bra'nch Circui ts
$ 40.00
$ 55.00
$ 80.00
see "B" aoove
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
deo~
/o.~
(f!< .:::1/0.=_