HomeMy WebLinkAboutPermit Electrical 1992-3-26
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225 FIITH STREET .pp"nf;'4^~r:p,.n', ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 r",.~1. " <lc.:/~;:~"I'6
INSPECTION REQUEST: 726-3769 S'" '!fi!~:~"<;i,<y Job N~be< 920 M,,--;7
OFFICE'. 726 3759 !.,~' "r,,_ ,Io:c:f.'o:""""'"
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fl,., ~'. . '_ OMPLETE PEE SCHEDULE BELOII
1. LOCAT!jN OF INSTALLATION"":r ('J,.~'r:lr, .'..... __
~3 ~MII Tn!. )"':l!'~,..LW Ne\l Residential-Single or
--.. ~l ti-Family per d\lelling uni t.
LEGAL DESCRIPTION Servi~e Included:
1'7D3 34 /2. CJC:.461~ -----_ Items Cost Sum
JOB DESCRIPTION
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.
Permits are non-transferable and expire
if \lork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Nanie_MMK <:::r.HI'Jl::N c-.~
Address (,;34- J!A,.,.,IL TC/J
I
City 'SP~. Phone 7+/-22$1
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
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( -- ----.f--------------------'--4-------,-----
DATE: ."'"'-~v~'Z"- . '.
RECEIP'f"#( ,. li 7 ~y .
RECEIVED BY: (1" "
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Modular Dvelling
Service or Feeder
B. 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
$ 85.00
o
$ 15.00
$40.00
$ 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
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
Nev, Alteration or Extension Per Panel
One Circuit L---- $ 35.00 3~~
Each Additional
Circuit or vith Service
or Feeder Permi t ~ $ 2.00' fC7D
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$
$
$
$
/f16D .
) ,"I J
-ft7.'TO
40.00
40.00
20.00
36.00