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HomeMy WebLinkAboutPermit Electrical 1991-12-3 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF J;NSTALLATION ;J S1 ::A 1--1r'J dt~&y. LEGAL DESCRIPTION nOd Iq~d-O 0'-100 POf_ JOB DES~PTION S.F ~s.;~('A., ??"lcl Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Gevtt--d Dec.1 Address ? 7 g7 DI"""!,, C #;2C City ~~~.cldPhone 74/--2SC;( Supervisor License Number 3 G <;:;<IS . Expiration Date /0 -1- '12 Constr Contr. Number~L)" (; 'lD Expiration Date J/-11~/ Signature of Supervising Electrician "J1d.~ Owners Nanie Address City Phone OVNER INSTALLATION 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: r~=?'\tj I \<,.ji.{ '=- - "S~::LJ SI."INGf:Il!LD Ci ty Job Number q Il 04 Y 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Hulti-Family per dwelling unit. Service Included: Items . Cost Sum .1000 sq.ft. or less J Each additional 500 sq. Oft or portion 5 thereof Each Hanuf'd Home or Modular Dwelling . Service or Feeder $ 85.00 <:;;<:;_00 $ 15.00 7S 00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 206 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 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 ampsor.1000 $ 40.00 $ 55.00. $ 80.00 volts see "B" above D. Branch Circuits New, Alteration or Extension Per Panel One Ci.rcuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Liniited Energy/Comm $ 36.00 5. Jj"o -o() <:,{.OO _' I~C;:. (11L- SUBTOTAL OF ABOVE 5% State Surcharge TOTAL