HomeMy WebLinkAboutPermit Electrical 1991-9-18
225 FIFTH STREET
SPRINGFIELD, OREGON 97477 .
INSPECTION REQUEST: .-:7~6:'37~ ~)O-...
OFFICE: 726-3759 .'" '" -( A 'l...J
'(,. I I 3, COMPLETE FEE SCHEDULE BELOV
, 1. LOCATION. OF INSTALLATION'.."., '..." '" 't,~I8i~j,;
4436 Ivy Street .........~ 'A. New Res1fdentia1-Single or .
,.... Hulti-Family per dwelling unit.
LEGAL DESCRIPTION . ~" S. ervice Included:
.18020521 07800 ~ ~ Cost
JOB DESCRIPTION f1 (\(?') ~ r1 E10aOcOh sq. ft. or less ttil..L $ 85,00
S F Residence r'V1 )~:J additional 500
- - sq. ft or portion (l
Permi ts are non-transferable and, expire thereof ;:) $ .15.00
if work is not started within 180 days Each Hanuf'd Home or
of issuance or if.work is suspended for Modular Dwelling
.180 days. Service or Feeder
Sl'fllNGFIELO
City Job Number
2. CONTRACTOR INSTALLATION ONLY
B. Services or Feeders
Installation, Alterations or
Relocation:
Electrical Contractor Rose Corp.
Address
89976 Day Lane
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
Ci ty Eugene
Phone 686-0905
Supervisor License Number 1568S
Expiration Date 10-1-92
q I ott<1
Sum
.B5
~
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number 54431
C. Temporary Services or Feeders
Installation, Alteration or Relocation
9-30-91
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Signat~Supervi~ Eiectrician
I /~./ /6--e
.0, Branch Circuits
Owners Name Capstone Homes, Inc. of Oregon
$ 40.00
$ 55,00
$ 80.00
see "Bn
above
Address
P_O. Box 22636
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
97402
Ci ty Eugene, OR Phone 689-5567
One Ci,rcui t
Each Addi tional
Circuit or with Service
or Feeder Permit
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
E.
Owners Signature:
~A~;~-----~~~2:(j--~--------I-----
RECEIPTtI:~,\~r<~
RECEIVED BY: \~ 11/_1~~!
5.
SUBTOTAL OF ABOVE
5% State Surcharge
. TOTAL
$ 35.00
$ 2.00
not included)
$
'$
$
$ 36.00
1 ?f). DU
/.il .::::'0
I ~If).:::~r)
40.00
40.00
20.00