HomeMy WebLinkAboutPermit Electrical 1993-5-21
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225 FIITH STREET _ ,
SPRINGFIELD, OREGON 97477 LOo1'T__.)
INSPECTION REQUEST: 726.:;37.69--.::./2:l j)
OFFICE: 726-3759
Au~hori~od Signature
1. LOCATION OF INSTALLATION
4493 Glacier Street
LEGAL DESCRIPTION
18 02 05 1 2 Lot 121 A
JOB DESCRIPTION
Single Family Residence ~cmT5
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 Rose Corporation
Address 89976 Day Lane
Ci ty Eugene
Phone 686-0905
Supervisor License Number 1568 S
Expiration Date 10-1-93
Constr Contr. Number 54431
Expiration Date 9-30-95
Signature of Supervising Electrician
4:2/A/~
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SP 66
9:.
~U"~~rE FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq.ft. or less I $ B5.00 ffi
Each additional 500
sq. ft or portion ~ 4Q
thereof \ $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations or
Relocation:
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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200'amps or less \ $ 40.00 4f)
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ BO.OO
Over 600 amps or 1000 volts see "B" above
D. Branch Circuits
Owners Name Capstone Homes, Inc. of Oregon
Address P.O. Box 22636
Ci ty Eugene, OR 97402 Phone 689-5567
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~-------:--~-~~~-t~~----'
RECEIPT II: ~ . _ ~')Y-o....:..,
RECEIVED BY~ ~, U )t:.'} -
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New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
40.00
40.00
20.00
36.00
not included)
" 5.
$
$
$
$
J 71200
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SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL