HomeMy WebLinkAboutPermit Electrical 1991-8-13
S..UINGt:IELD
225 FIITB STREET
SPRINGFIELD, DREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. A 1t0qTPlN ~ INST~N .11 _..\--'.
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LEGAL DESCRIPTIOJ2J . -'. .
,.JOB,...QESqR1:PTION ~ _ ro.
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Permits are non-transferable and expire
if work is not started within 1BO days
of issuance or if work is suspended for
.180 days.
2, CONTRACTOR INSTALLATION ONLY B.
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AddressPAC\\ ~ 0 \:\~A O:}0
Ci ty fA. "D' Q ill , Phone \ 0 ?\l~ ('53(b
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Supervisor License Number ,~~~
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Expiration Date
Constr Contr, Number ~L\ L\- ~
Expiration Date
ex. :~D C\ \
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-----F-=~7------ i--------------
DATE:l<">\,.'QJ,, . \ 3 . G\. ~'~-=R 'S''T
RECEIPT t1: ~ ~ .
RECEIVED BY: \. .::;j~>
City Job Number
3. COHPLETE FEE SCHEDULE BELOV
q \~\51
A. New Residential-Single or
Hulti-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq.ft. or less I $ 85.00 ~J:&O
Each additional 500
sq. ft or portion :3 Lf~ to
thereof $ 15.00
Each Hanuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
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
$ 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 amps or 1000 volts
D,
Branch Circuits
signatur~upervising Electrician
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, 1\ -L-.. ~ .
Owners Name \.. ~~~.'\\ j'{ \ Q ./
Address \)() ~ 8~lo3(Q
(\ . I .cr1 e,=,! J\ One Circui t
Ci t~ X .-\ ~r1Q Phone UJ ~~\ '~\.O I Each Addi tional
Circuit or with Service
OVNER INST LATION or Feeder Permit
$ 40.00
$ 55,00
$ 80.00
see liB"
'M, ()O
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABDVE
5% State Surcharge
TOTAL
$ 35.00
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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