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HomeMy WebLinkAboutPermit Electrical 1991-11-18 v 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 City Job Number OFFICE: 726-3759 1. LOCATION OF INSTALLATION 4467 IVLl 5treet LEGAL DESCRIPTION 18 02 05 24 TL 1500 JOB DESCRIPTION 5 F Residence Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for IBO days, 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Rose Corp_ Address 89976 Day Lane Ci ty Eugene Phone 686-0905 Supervisor License Number 15685 Expiration Date 10-1-92 Constr Contr. Number 54431 Expiration Date 9-30-92 signatu~Supervising Electrician / /dr~./ ~ 3. COHPLETE FEE SCHEDULE BELOV A. New Residential-Single or Hulti-Family per dwelling unit. Service Included: It ems Cos t Sum 1000 sq.ft. or less Each additional 500 sq.: ft or portion thereof Each Hanuf'd Home or Modular Dwelling Service or Feeder -- $ 85.00 ~oe. "3 $ 15.00 ~...... $ 40.00 B. 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 $ 40.00 $ 55.00 $ 80.00 see "Bit above D. Branch Circuits Owners Name Capstone Homes, Inc. 6ff Oregon Address P.O_ Box 22636 CityELlgene, OR 97402 Phone 689-5567 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: II-, \7 -0 I RECEIPT #: ')."yO RECEIVED BY: 'l\JV'l New, Alteration or Extension Per Panel One Circuit 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 Lightin~ $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE /? tt:? 5% State Surcharge 6, ~ TOTAL I '3.&;.~