HomeMy WebLinkAboutPermit Electrical 1992-4-10
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~. (1(\\, es .Pec-;it/CIEIIE.~&L P'ERHIT APPLICATI, ON
97477 ,.~onln \'>-.:-/ nf'\'.......c:r1L
726-37fi~e .' . -7 - Ci ty Job Number '--'\ Ol~ \ .
AUII10tlzOd S L.
IGnature~IIPLETE FEE SCHEDULE BELO\!
LOCATION O~NSTALLATION
;<)72.-0 (7Ov+-fIfJCUi\ 0-. A. New ResidentTal-Single or
-1 Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
11 O~ 7_7_ 7.-CJ - 02-'-10"0
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
JOB DESCRIPTION
i'lY\ c.... c::: ':] V\
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. CONTRACTOR. INSTALLATION ONLY B.
Electrica~ Contractor4fSktpl dZM Slee-.
Address 71,:::)7) :t3J)(' JL- SI--.
City E---(J{d~ . Phone 0Y:4 -7276'
Supervisor License Number 1-41--t;'C7
Expiration Date 1/-/- q V--
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
- 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
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number 'f J ~ 7 /
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
1---C;-QJ
-' -'
x:c~ervi~cian
. --' .J.. / . D.
Owners Name (a t:...D ~.1?-e!/ {;{/e"hey ~
(oF;?Y Nt id.II"b-c>Yt ~
Address.5)~2~t)d-e.'-'J(JJ -'
Ci ty f3,u.qpiA9- Phone b?7-~4lf1)
, .'
OVNER INSTALLATION
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
07Zi::;:&/J/i~Lr
------------~----------~--------------
DATE: L.j-/cY-9<. ",__,
RECEIPT #: ., -"/---X,/ I
RECEIVED BY: ~./YJ.-./
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Ouiline Lighting $ 40.00 ~
Limited Energy/Res $ 20.00
Limi ted Energy /Comm ' S 36.00
5. SUBTOTAL OF ABOVE 4-0. c::X:l
5% State' Surcharge 2..-CV
TOTAL Lf 2--,00