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HomeMy WebLinkAboutPermit Electrical 1992-7-1 j"'IIN(;.,'Il..:.l..,U. 'n-:" FCilo~/:-' ~~ ~~n;.;g. P.r.~.jJ projeCt !Is ... . ~.. 225 FIITD STREET apr;:Cvol. '" etCOJ ,,<,( ro,~~bmlft.ci r!t~rnICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 1fP)'''rOOPtlCffICJ~d tOI/Olttng' f1 (\()~ () INSPECTION REQUEST: 726-376?..r., ~onir.L'Q.. Ci tyUOjob Number '-t rt .... l~ OFFICE: 726-3759 '-~,L=----- . r ~ __ 1. _<\II.. OU~STr;".~"~ ~..:""" ,'!I'U'" PEE SC1IE1lOLE BELOV Lr')N(')l) 'G\('j I. ,e'Hf\l ~~Ov ~_~ntial-Single or Hulti-Faml~er dwelling unit. LEGAL, DESCRIPTIO /'?v'VI /""-\ I Servi ce Included: ( 'I nA ()9(Y) U .TR./ Items Cos t Sum ~~!.!: €:~:~~;'::b~"i" if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor~f((; ~/q~~~. Address~) S7 A("JY') .JJ. City ~},ll'11f"l) Phone 7i/(P-l/bSto I Supervisor License Number ~,~ Expiration Date I () - J - q d Constr Contr. Number Ii 5 Ia.q 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Modular Dwelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: $ 85.00 $ 15.00 $ 40.00 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 40.00 1Gi":iremriorarY,ise~",1fc;s1br Feeders Installation, Alteration or Relocation Expiration Date .4- aLl-q.~ Signature of Supervising Electrician .~,th ~.& JJI&'~ , Owners NameIfn..Jen? ) t11Jl Address9'52{1~ 'Ni J 1 j.J:g Ci t.j ,~ (U 0 t; ). = Phone<J141~ IJdO ~ER INST~LATION The 'installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~~~----7J~-1~-'1'~--~~-~---------- RECEIPT #: ~, /), ~:...t........, RECEIVED BY ~_n . - 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 volts see "B" 40 above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting ,Limited Energy/Res Limited Energy/Comm One Circuit Each Addi tional Circuit or with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 $ 2.00 not included) $ S S s 4!2,~ ""r~.CO 40.00 40.00 20.00 36.00