HomeMy WebLinkAboutPermit Electrical 1992-7-14
:~", fOllo\Vin~ project lIS s..:brr.llted t>!il the fol ~..
,.nmG, and wOOS not "'Guire speciflo land use ~~
:pprOi.'c.f. . '
225 FIFTH STREET ' , . ~() ') ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ~onln f'U I"7LlI'\/')/~/-
INSPECTION REQUEST: 726-32~....j: . .0' , City Job Number ~lo( J1~
OFFICE: 726-3759 ',--L ( .
, , 1-\liIhClliZlxl S;gn;tuf"~u",,,,,,,, """ SCHEDULE BELOV
1. LOCATtON OF IN~TAJJ.ATION
j. 'Ot) 't.IJL.I~ ..cJh. './'1-' _ A. Nev Residential-Single or
, 0 110~~'/cO~Multi-FamilY per dvelling unit.
~~GAL pESCRIPTJqN ~ ~ Service Included:
(, ~J1..JJ)r,k-l-?lLl,L. Items Cost
'tr . j
JOB DES~I~N
{} ~ y-' ;Lg 3-M03 goo L
Permits are non-transferable and expire thereof
if vork'isnot started-vi'thin 180 days..---'-Each Manuf'dHome 'or
of issuance or if york is suspended for ' Modular Dvelling
180 days. Service or Feeder
e)
Sum
1000 sq.ft. or less'
Each additional 500
sq. ft or portion
$ 85.00
$ ,15.00
$ 40.00
B. Services or Feeders,
Installation, Alterations or
Relocation:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ,4 7J r
"
Address 7t'3 tV E /{/J#t!.(Jc/<
Ci ty.{J.lJ X q 7z--/'Z- Phone / -uL/. 3zh5
-
Supervisor License Number 19.....1.) Lt-
~xpiration Date 10-1-9-3
Constr Contr. Number.;;;z.59ftfcf
Expiration Date '-/ -2--'1- q~
200 amps or less
201 amps to 400 .amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnec t. Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
e)
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
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
~Signatu~e.of4SupeEV~s4ngfE~ect~t~ian"
o~, '. N-~Cf\rfi~. D.
Address 68.\\J~9J)'-
City' ~~. Phone~VJ-3J.<6
OVNER INSTALLATION
Branch Ci rcuits
Nev, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or uith Service
or Feeder Permit
$ 2.00
The,insta1lation is being made on
property I ovn vhich is not intended
for sale; lease or rent.
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 ,jblJ~ /...?
5% State Surcharge, (>Jv ~>.- ~'e.:'
TOTAL 3s,-Ji'p
Ovners Signature:
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RECEIVED BY: . ~-
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