HomeMy WebLinkAboutPermit Electrical 1993-12-20 (2)
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225 FIFTH STREET ",-I" ;'.o;..,~.~-,-~ ?-o--~ ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 97477 1~ll,J3>,j";). ~
INSPECTI~N REQUEST: 726.J..31~G\gn;;,.,,\e.>> Ci ty Job Number q ~71!''::::'
OFFICE: 726-3759 ~,u\ho"Z.'-
1. LOCATION OF INSTALLATION
p,"':? 7C::- h-o.fro1lt-"L5..F-,
5;7r",I')f.>bI (, V- '17'177
LEGAl. DESCR!P'1'IQN '
17"Y2'3-2'2-:<!<I!> ~-9~/
JOB DESCRIFTION
7111-1-1-"<",'f!/'I ,<>;, ~..I: 1t1"'~fV- 5.cQr....l"
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 B.
Electrical Contractor A L. lSJ,,/<:!nr i 501't5
Address--1L!3(n 4f-"~ M~/
Ci ty yifv,t,'/~~o Id.,PhoneQ06,) 7Cf.Jl/" '1"/
Supervisor Licen,se Number 1</ J7 /4..1-
Expiration Date //-9#
Constr Contr. Number ?'7- t, 2 {, ~L E
Expiration Date //-s'Y
Signature of supervising~ician
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Owners Na~~ (Y ApII ....0//0 (/ ').A,
Address
City Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE:, I~-::r-"~
RECEIPT 11: /~?
RECEIVED BY: ;~ r
3.
COMPLETE FEE SCHEDULE BELOV
A. New Residential-Single or
Hulti~Family per dwelling unit.
Service Included:
It ems Cos t
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D. Branch Circuits
New, Alteration or Extension Per Panel
One Ci rcui t
Each Add it i onal
Circuit or yith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm X' $ 36.00 ..3:'i2
5. SUBTOTAL OF ABOVE ~-
5% State Surcharge ' / .g.::J-
TOTAL ' "?f'? gtt5>