HomeMy WebLinkAboutPermit Electrical 1992-6-26
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1,h;', IOii"vdr:g,pmjoctaB oubrnrttod has tho followin. .~,
225 FIFTH STREET l.,..,ng, ""'" OC05 ~cl requiro spoejj;-Iand u.o ~LECTRICAL PERMIT APPLICATION
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SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-g'l'69" CC
OFFICE: 726-3759 Dete (.,bie./ci';;J
1. LOCATION OF INST1i.Ltli'rr(iNgn3:u,"~ ,
7/0 /77/1IAJ <;7
Ci ty Job Number "72 ~7
'*
3.
COHPLETE FEE SCHEDULE BELOV
New Residential-Single or
Hulti-Family per dwelling
Service Included:
A.
uni to
DfP(i)
LEGAL DESCRIPTION Jl b'::> :,'9-1;)
7iCll"J'~ u.Jt}y />?07771f CO,
Sum
Cost
Items
JOB DESCRIPTION Rb"'tVV1!:. CILC> C./f'C.U'T1 ...
/n.r771t.L CJ~17\ If) JVEt<.J /)..JIiLtf
$ 85.00
1000 sQ.ft. or less
Each additional 500
SQ. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 15.00
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.
Electrical Contractor KLofMj<lS::,nr E/..H:reJc
Address :stz.:I C~ ILl:> r:,,, -,c"o
$ 40,00
Services or Feeders
Installation, Alterations or
Relocation:
$ 50.00
$ 60,00
$100.00
$130,00
$300,00
$ 40.00
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
Phone tH'/78'r
Ci ty &..~
Supervisor License Number ~~03~
Expiration Date /~ -/ - 9?
Constr Contr. Number 7fJ1"'9
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
,$ 40.00
$ 55,00
$ 80.00
see liB"
Expiration Date I'd? (J 9Z
Signature of Supervising Electrician
~/ ~c.k2
above
D. Branch Circuits
Owners Name ')?to(' /:J -f'1..a~
New, Alteration or Extension Per Panel
Address_32U ~ Ki>
$ 35,00 j"S-:-o 0
One Circui t ~
Each Addi tio'nal
Circuit or with Service
or Feeder Permit -;
Phone ~k-r;; /7!i J
Ci ty Gt/G.€-nlE
$ 2,00 1<j.,60
OVNER INSTALLA~ION
E. Misc~llaneous ~Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting S 40,00
Limited Energy/Res S 20,00
Limited Energy!Comm S 36,00
The 'installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
,l/? 01:)
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DATE:
RECEIPT #:
RECEIVED DY:
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