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HomeMy WebLinkAboutPermit Electrical 1993-8-31 "O~i 0116...!." e/J "g, e "Ojf;;" :OrOI'~1 f)rJ do^ Olec,' , . ...,g as' 225 FIFTH STREET .?; "OI'r09~7/j"'itterJ' ELECTRICAL PERMIT APPLICATION # 69 SPRINGFIELD, OREGON <yJl!]7 Of)i"r;~n" re ./JcOiy;~es'lho q.'J... " crfsP INSPECTION REQUEST: -'l 726-3,7690":" '() . "le!)rJ;'?l,(,a!tity Job Number ...)l )T--l OFFICE: 726-3759 "1.~C/"v::-'~(;Y.' I .... 'fJ " &;");~'i " COMPLETE FEE SCHEDULE BELOV 1. LOCATION OF INSTALLATION "/~...... I J. 4461 Glacier street ~ New Residential-Single or Multi-Family per dwelling ~ice Included: . LEGAL DESCRIPTION 18 02 05 2 1 TL 4200 JOB DESCRIPTION Sinqle Familu Residence 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 Electrical Contractor HAV<:.<<. II1fv,,,,-' ~"".i- Address ~53 ~. (,.~!i' t"'- PL.. Ci ty 5P-li> CI(' Phone J<-i'-l -I I I.S '17~"lY Supervisor License Number 3571 S Expiration Date)o-I-1S- Constr Contr. Number.&' "/"1'2.3/;:' Expiration Date ::(-5-gLj. SignatU;jf ~ Electrician Items 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: \ ~ uni t. Cost Sum $ 85.00 ~ $ 15.00 21) $ 40.00 200 amps or less 201 amps to 400 amps 401 amps to. 600 a~ps. 601 amps to 1000 amps Over 1000 amps/volts Reconnect qnly " $ 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" 4/') above D. Branch Circuits Owners Name Caps tone Homes, Dic, of Oregon , New, Alteration or Extension Per Panel Address j:>,B. Box 22636 City Eugene, OR 97402 Phone 689-5567 OVNER INSTALLATION The installation is beirig made on property I own which is not intended for sale, lease or rent. Owners Signature: -------------------r-A~-------------- DATE: A .3.\ .~\~ RECEIPT I: '0' '~( ) , RECEIVED BY: - 'd- \,l /-':-'{' _ / One Circuit Each Additional 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/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE \S~90 5% State Surcharge ~.~~. TOTAL \ ~o.!4. . I J..:i