HomeMy WebLinkAboutPermit Electrical 1993-6-28
The following project .s sue...:::. ~ : ~_lhe foil tI~
zcr,lng, and does not require specific land use . .-
.~poval. ELECTRICAL PERHIT APPLICATION
97477 Zoning 0e-
726-376~",?~ _~ . Cf/ \.01 ty Job Number
Auiiw,zad Signature 3 ~PLETE FEE "SCHEDULE BELOII
LOCATION OF INSTALLATION
~~\. ~r->:~ ~~"'C\::>~
225 FIF11I STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
LEGAL DESCRIPTION
n b?),<; 2, J
f :ll.OO
JOB gESCRIPTION
-dee... ~1'~
Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contracto~"^~~,, '\
Address '-\"'"'''''',
,,~, .;:0,.. Ci~~""""
~
Phone '-\'i-..i:::; - \.~\'-11....1
Ci t~ '-. ("'(,:) lAC'>
, '-...-=>
Supervisor License
Number
Expiration Date
q~oCX J')
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
A.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
. thereof
Each Manui'd Home or
Modular Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations or
Relocation:
Items
Cost
Sum
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
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
*
Constr Contr. Number ~'\J- \,=,,('\. 'S-..
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising'Electrician
~Jll rrJ_~J~ _ D.
Ovners Nallie V~c.K S ~iJc:v--J
Address ~:J. \ VY\ C;U;", j ~ opt
Ci ty 'S:.-flV' ""J ~""\d i, Phone il..f I - 6Y toy.
01lNER INSTALLATION
The 'installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
~~~hu~~
( ...".,./ .
~A~~-------- vl~\~~ ----------------
RECEIPT #: q:r:l,')
RECEIVED BY: ,0:>,
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Ci rcui,ts
$ 40.00
$ 55.00
$ 80.00
volts see "D" above
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightiny
Limited Energy/Res
Limited Energy/Comm'
One Ci.rcui t
Each Add it ional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
S 35.00
$ 2.00
not included)
\
$ 40.00
$ 40.00
$ 20.00
$ 36.00
-::z,'-.:,.I:::>~
'""?-:k, . \::"\ ~
\. ~'"
.-...,", . C6C'\