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HomeMy WebLinkAboutPermit Electrical 1991-5-28 225 FIFTH STREET '," . SPRINGFIELD, OREGON 97477 . .INSPECrION REQUEST: .726-3769' OFFICE: 726-3759 1. LOCAT}:ON OF INSTALLATION. '2L4.3 l.o(VM.Ihf';" . LEGAL DESCRIPTION J'2t:?3 2 c.,:.. J. 2- lJdt,tJ I) JOB DESCRIPTION A:tJl) ."'iEW/LJ), A'AJ < 86V-MhI 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. CONTRAClOR INSTALLATION ONLY Electrical Contractor . Address City . Phone Supervisor License Number '.. Expiration Date . Constr Contr. Number .Expiration Date Signature'of Supervising. Electrician The'installation is being. made on property I .own.which is not. intended . for sale, lease or rent. .. fY;ZQ~ I. . ---- 1~'irE:S '7.~-'-{ __ '. RECEIPT I: - ~_ A ( JI t\.d-. . RECEIVED BY: \. '/IU, [~ I ELECTRICAL PERMIT APPLICATION City Job Number 'Cj'/04 ~<: 3. COMPLETE FEE SCUBDULB BELOV A. ~ New Residential-Single or Multi-Family per dwelling unit. Service Included: 1500 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder Items Cost Sum $ 85.00 $ 15.00 $ 35.00 B. Services or Feeders (10 Branch Circuits 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 $ 90.00 $130.00 $300.00 $ 35.00 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. Branch Circuits '. owner~ Name~ 0 .. Addressr9\4~ . . . Citymi({ · . Phone J4h{jo_~O . . o~ ~STALLATION $ 35.00 $ 40.00 $ 80.00 see "B" above New, Alteration or Extension Per Panel E~ Miscellaneous (Service/feeder -Each installation Pump or irrigation. Sign/Outline Lighting . Signal Circui t or Umi ted energy panel One Circuit .Two .to ten Circuits Each Addt'l ten or portion thereof 5. SUBTOTAL OF ABOVE . 5% State Surcharge TOTAL $ 35.00 ...---- $ 50.00 ~"rO $ 15.00 not included) $ 36.00 $ 36.00 $ 36.00 <5,r).':J 0 2,50 .~?,.. So