HomeMy WebLinkAboutPermit Electrical 1991-10-28
225 FIFTH .>.""".
SPRINGFIELD, OREGON 97477 ~
INSPECTION REQUEST: 726-3769 City Job Number q II Z 7 /
OFFICE: 726-3759
1.
LOCATION OF I]{STALLATION
,7/':;-7 1Tr'n?.J.€z!L&"
" '
gJ,
LEGAL DESCRIPTION
/'7t!J;:> )'7 610 &:?s ~~
JOB DESCRIPTION
S~/C:C ~6
Permits are non-transferable and expire
if york is not started vi thin 180 days
,of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor BlAt f d~LC:
Addr~ss ;2..93 /Jtnul /?/>~
Phone Y' Y>.s - 0 9' J.. ?-
3. COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
A.
Items Cost
1000 sq. ft. or less
Each additional 500
sq. ft or. portion
thereof
Each Manuf'd Home or
Modular Dwelling
,Service or Feeder
Sum
$ 85.00
$ 15.00
$ 40.00
B. ,Services or Feeders
,Installation, Alterations or
?''!<:<11(:' Relocation:
Ci ty 7"<< ~ .....-' c
I
Supe~visor
Expiration
License Number b< t? ? cr
Date /C? -/ ~ j?.;L.
s
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
~ $ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
s-01!e:L
Constr Contr. NumbertJ '/ .:LP6
Expiration Date/:2 - /(;) - ;? /
C. Temporary Services or Feeders
Installation, Alteration or. Relocation
Signature of Supervising Electrician
&:~ C~
/'
Owners Name
Address
City
Phone
O\INER INSTALLATION
The installation is being made on
'property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: /c/ -2 'b - ~ /
RECEIPT I: '7/ /:; ')'~
RECEIVED BY: - '''t~
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps 'or ,1000 vol ts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
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 Ci.rcui t
Each Addi tional
'Circuit or with Service
or Feeder Permi t
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
I
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
~~O trt)
?~
~2. :>,0
I