HomeMy WebLinkAboutPermit Electrical 1992-9-8
lJ~i."";(! pr . . . tI,
225 FIFTII STREET .pp;~~' j"net rl<e~je,'C, as sUbrnilt ELECTRICAL PERMIT APPLICATION
a ." at fee. . edh
SPRINGFIELD, OREGON 97477 ~r7'UI} SPeci/ic.: th. fOifowin
INSPECTION REQUEST: 726-3769 ~oning IU andt:JliJty 90b Number ~d/;)3i
OFFICE: 726-3759 Oate ~'<?: - ''7_____.
AlJIho-:- -~ <..- 3. --COMPLETE FEE SCHEDULE BELOII
1. LOCATION OF INSTAL41IO~Z.d Si97ature
1?5.) ~bh /.5n'~ 1/{d. New Residential-Single or
/ mily per dwelling uni t.
\.~~S~\N \ \ \ocV Service Included:
JOB DESCRIPTION
1/)1.1 11t1(~ W;ru.... f/
~
?ermits are non-transferable and expire
if work is not started within 180 days
of issuance or if york is suspended for
180 days.
,1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~ /A~'
B. Services or Feeders
Installation, Alterations or
Relocation:
City
007
ECJ' .
tv. S-'i}... ;rUe.-
Phone 3'/'f'..;) 9'-<f /
Supervisor License Number ;;< 9S 4h.f
Address
Expiration Date 10- /- 92.
Constr Contr. Number ''/o5r-J
Expiration Date I-:J- '-;;-1- f:J-
;gz~~t:;;; Electrician
, Owners Na~J /(1) ~//ffu -
Address 1 Id_~,!f~d;A-, ;;,~,{/?~.
Ci ty s;~ 1/& Phone '71'6 _)tiff'
V OJ!
O\INER INSTALLATION
The installation is being made on
property I oyn which is not intended
for sale, lease or rent.
Ovners Signature:
~~~;~------q~M~ Y *---~---------
RECEIPT #: l n ,( t7 /....-=<, ()
RECEIVED BY: ~j_'Y\.
200 amps or less $ 50.00
201 amps to 400 amps S 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
201 amps to 400 amps
Over 401 to 600 ,amps
Over 600 amps or 1000
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above,
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$
/ ~
$ 36.00
dO. CO
f.OD
OJ /. 00
40.00
40.00
20,00
r:-<LI )