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HomeMy WebLinkAboutPermit Electrical 1991-1-3 SpnlNGFIELD 225 FIFTH STREET , SPRINGFIELD, OREGON 97477 ,INSPECTION REQUEST: 726-3769 ' OFFICE: ,726-3759 1. I,OCA'lJON ,01 INSTALLATION, . , . 5Ji'::!IJ #dUal!?/J .t8Pa4..e.. / LEGAL DBSCRIPTION , ' J.QO f::J ,~, () () (')o!)Qn ,;,' JOB DBrCRIPTION '. 0 ' , I O~ 0 r':t 'TV, <..~~, Po J;::u" Permits ar 10n-transferable 'and expire if work is not started within 180 days of issuance or if work is suspended for 180 dars. 2. CONTRACTOR INSTALLATION ONLY Electrical contract~()~, ~ Address ffiC\"l \. Q \::x\ '1 \ rftu. ' City f....cD Q.f\Q.. ,Phone l o~N1m . () - . Supervisor License Number J ~I Q9-S , Expiration Date_/O.L9~ ,"c~nstr Contr. Number~(\?:> I 9.3[).Q\ Expir,ation Date S~gn~~~~erViSing Blectrician TX'~/?~ . ," "Owners Name...ft-O ,If', l<<l~Q 0 f( ') , Address~ {)IOJid;) , <:i ty.sSptJ rt.', ,PhO~~ !}1(0-8/KS , ,OWER USTALLATION The installation is being, made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: , RECEIPT I: RECEIVED BY: /-'3-q/ /q" I./'J. ' . #'~.H~~ ".-... , ELECTRICAL PERHIT APPLICATION City Job Number . Q{)/4P{!) 3. COMPLETE FBE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1500 sq.ft. or less I $ 85.00 ~5 Each additional 500 sq. ft or portion d ?2D thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 35.00 B. Services or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: 100 amps or less 101 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 35.00 $ 60.00 $ 90.00 $130.00 $300.00 $ 35.00 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 $ 35.00 $ 40.00 $ 80.00 see "B" above D. " Branch.,Circui ts New, Alteration or Extension Per Panel One Circuit ,Two ,to ten Circuits Each Addt'l ten or portion thereof $ 35.00 $ 50.00 $ 15.00 E~ Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Signal Circuit or limited energy panel not included) 5. $ 36.00 $ 36.00 $ 36.00 -LI E) .cO ~.?"" -a/ 5. ry" SUBTOTAL OF ABOVE 5% State Surcharge TOTAL