HomeMy WebLinkAboutPermit Electrical 1997-7-16
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ANy 180 VA y OfT IS ASAN.'D PERMli Ircf.i't~NERHIT APPLICATION
97477 PERIOD ONED /!' ~Zed Signature. a J / /J 01-.
726-3769 .' rOFti ty Job Number l -+ I crtH--7
3. COMPLETE FEE SCHEDULE BELO'W
1. LOCATION G'ALLAT '-
/7-0"3 - 2 ro - 2 -,$ 1ft; 00 fnODll <600
LEGAL DESCRIPTION
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JOB DESCR1PTION <L,4sr-p/(J:"dI<-PAN<fU411000 sq.ft. or less
- _-~-- -_" ~_.'_ -' ~- -0- ,- -E;:tc.h'-add:?.-tlon3.1.-500-
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
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 B.
Electncal Contractor /)TOM Decll(/c...
, ,
Address, 9.$.3 Cunrll'^lJhA"':' -' ~/, Sl)
Ci ty SA lem Phone(503)36~"/38Z.
Supervisor LIcense Number 1f~J1e;-~
ExpiratIon Date /t/ ~ ~ j'
// /_'2' ccy6 C.
Constr Contr. Number ,/,/9223 f,2f-360-'-'
ExpiratIon Date /D /; J 17
f ,
e f Supervising El trician
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1/\ "W/~ c~..-- () .J:I~ '1. r /l.' L. f'
ers Name-rtiV)1'1 L- [1/1 htrr (laf21:~t1/
I
Address /'7 &'19> 56 IILfI'LAlI(L 'St-e /I(J'~II/
Ci ty'a(Ct6~a,lM~ ~ Phone fa 5& -70L(G-/
OVNER INSTALLATION
The installation is b~ing made on
property I own which-IS not intended
for sale, lease or rent.
Owners Signature:
~~~~~----~-tT~-/z.v~~---------------
RECEIPT #: I .;2(l? 7~ ~ . .
RECEIVED BY: ~ 1IlI1.A,(/\
A.
New Residential-Single or
MultI-Family per dwelling unit.
SerVIce Included:
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 60b amps '
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Items
Cost
Sum
$ 85.00
'::;O-T--__~ - -
$ 15.00
$ 40.00
$ 50:00
$ 60.00
"$100.00
$130.00
. $300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less / $ 40.00 4D.'()Q
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
Misc~llaneous (Service/feeder
-Each installiti6~'
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
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
40.00
40.00
20.00
36.00
$
$
$
$
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