HomeMy WebLinkAboutPermit Electrical 1992-7-1
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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