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HomeMy WebLinkAboutPermit Electrical 1995-8-7 /,,~... .' .,~. . . ' Zoninn LDL 225 FIPTH STREET 0,\., <?:bL9S SPRINGFIELD, OREGON 97477 Author;,,,,, Si9"~turo tVM INSPECTION REQUEST: 726-3769 ," OFFICE: . 726-3759 . . ELECTRICAL PERHIT APPLICATION ~: ~.I-.Jo&-Nlimber 9 (;;'{)(II 1/ 3. 'COHPLETE PEE SCHEDULE BELOV 1. LOCATION OF INSTALLATfOt;l :;?<:::L! { 0r~al , /i.s1-7A. A. LEGAL DESCRIPTION 12jl':<; ~ '-I n 0 ~_ Do 7J:2!1 -hOB DESCRIPTION , '1/ (JA Jyl- Xl /rJ---bm :{-n sh 16 h an . I. , Permits are n.on-transferable and expire if y.ork is n.ot started vithin 180 days .of issuance .or if y.ork is suspended f.or 180 days. 2. CONTRACIOR INSTALLATION ONLY Nev Residential-Single .or Hulti~Family per dwelling unit. Service Iricluded: Electrical Contractor , Address City Ph.one Supervis.or Licen~e Number Expirati.on Date Items C.ost Sum 1000 sq.ft. .or less $ 85.00 Each additi.onal 500 sq. ft .or p.orti.on there.of.. $ 15.00 Each H.;.nuf'd H.ome .or' H.odular Dvelling Service .or Feeder $ 40.00 B. Services.or Feeders Installati.on, Alterati.ons .or Relocati.on: 200 amps .or less 201 amps t.o 400 amps 401 amps t.o 600 amps 601 amps t.o 1000 amps , Over 1000 amps/v.olts Rec.onnect Only $ 50.00 $ 60.00 $100.00 . $130.00 $300.00 $ 40.00 C.onstr C.ontr. Number C. Temp.orary Services .or'Feeders Installati.on, Alterati.on .or Rel.ocation Expirati.on Date Signature .of Supervising Electrician .Ovners N3;me ~ oJ- f)d11U1 lIAJ!rk; D. Address-z:'Y7G ,/f,J (klc'7~;<i- Ci ty ~f.vet _ Ph.one () R OVNER INSTALLATION The. installati.on is beirig made .on pr.operty I .oVn vhich is n.ot intended f.or sale, lease or rent. .~ Signature: \v~A//A /"'DATE~-tJi3T77tf5'- RECEIPT, jj: / Hio'P.::s 200 amps .or less $ 40.00 201 amps t.o 400 amps $ 55.00 Over 401 t.o 600 amps $ 80.00 Over 600 amps .or 1000.v.olts see "B" ab.ove Branch Circuits Nev, Alterati.on .or Extensi.on Per Panel 'One Ci rcult Each Addi ti.onal , Circuit .or with Service, .or Feeder Permit $ 35.00 $ 2.00 Miscellane.ous (Service/feeder n.ot included) -Each installati.on Pump .or irrigati.on' Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% 'State~Surcharge TOTAL ' $ 40.00 $ 40.00 $ 20.00 $ 36.00 ::; 0 .trD { :;2-0. CJl) {.O'o '<.120 ~/. /ID