HomeMy WebLinkAboutPermit Electrical 1997-1-15
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225 FIFTH STREBT J~:jS ~tn
SPRINGFIEUl, OREGON 97477 D<\:,,_-
INSPECTION MQUE'ST: 726-3769'ctr,o'i,oo'Signaturo rJ /V\
OFFICE: 726-3759
1. LOCAT~ OF INSTALLATION
'~:;::!. (SalIIS/(t<>-i,.')
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, ~B DESCR,tPTION 'AJ".'I. .J
G ' IJtraJeX ,F",,\ UJ/'Iet!i'c'
"qf 'iJlJf#UA/6 mll-U1//1/e:-. ,
Jt1 Perm ts are non-transferable and expire
if 1I0rk is not started'vithin 180 days
of issuance or if'lIork is suspen~ed for
180 days.
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2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractort.~,1.5~6~~~AV~
Addressbf tl)ar "4>" <;;ne....
Ci ty '5?R IIv'Gne-t-1J Phone 71/- 7- a~ J
, -
Supervisor License Number /1735
EXPi:ation Date /0///11
Constr Contr. Number t)t?i?91
Expiration Date Id/IJ:/r17--
Si~a }Ure of Supervi~ing.;' ~ec trieian
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o:ne~~ame f!7@fcKU ~OUI#<-
Address .5OtJO Glt-n::w1H/
City S~f-~ , Phone'
ELECTRICAL PERHIT APPLICATION
Cit" Job'NUlllber q 70/3 c.(
3. COMPLETE FEE SCHEDULE BELOV
Nev Residential-Single or .
Multi-Femi1y per dvelling unit.
Service Includedl '
Items Cost
Sum
1000 sq.ft..or less ,$ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Kanuf'd'Home or
Modular Dwelling
Service or Feeder $ 40.00
Services or Feeders'
Installation, Alterations
. or Relocation:
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
OVNER INSTALLATION
The installation is being made on
property I Olin vhich is not intended
for sale. lease or tent.
.
Ovners Signature:
---------------71~---------------------
DATE: 1-/<>"'/7 . .
RECEIPT 1I: "'L-'1;z. 1"1
RECEIVED BY: /I~
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200 amps or less - $ 40:00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 100v VO.Lts see "B" aoove
D. Branch Circuits
Nell, Alteration or Extension Per Panel
$ 35.00 35 &0
One Circuit
Each Addi tionil
Circui t or vi th Service/
or Feeder Permit
/
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$ 2.00 17)
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm _____
E.
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SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
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$ 40.00
$ 40.00
$ 20.00
$ 36.00
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