HomeMy WebLinkAboutPermit Electrical 1992-05-26st'tttN(;FtELo
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225 FTVTE SM.EET
SPRINGFIELD, OREGON 97477
IJGAL DESCRIPTION
JOB
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Permits are non-transferable and, expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COI{TRACTOR TNST ONLY
Electrical Contractor
Address
citv4--a L^r) &1 . Phone 6,k8 'Xs Yg
tr
Supervisor License Ntimber
Expiration Date 1o -/ -2L
constr contr. Number eO*/7'c
Expiration Date /0-/-7L
Si ture of Supervising Electrician
Ovners Name
Address 381 f.l. lbtt^- (+
Ci ty Phone )9rrOC" V
OVNER INSTALI,ATION
The installation is being made on
property I ovn vhich is not intended
for saIe, lease or rent.
Onners Signature:
DATE:
RECEIPT *:
3. COHPIJTB FEE SCEEDULB BELOV
A. Nev tial-Sing1e or
HuIti-FamiIy per dvelling unit.
Service fncluded:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Eact Manuf'd Home or
Modular DveIling
Service or Feeder
-/- $ g5.00 _6
$ 40.00
Services or Feeders
Installation, Alterations or
Relocat ion :
CAL PERHTT APPLTCATION
Job Number ZLo s Ll3
-/- g 1s.oo 4o
INSPBCTION REOIEST: 726-3769, - . .'
OFPICE: 726-37ss h 5/b
Ci ty
1. LOCATIONs?s1 (oP rus?Alrtrfldh"Iro!\ sI
Sum
B
6 zr-s
200 amps or less
201 amps to 4oo amps
-401 amps to 500 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0n1y
STIBTOTAL OP ABOVB
5X State Surcharge
TOTAL
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/0utline Lighting_ S
Limi ted Energy/Res $
$ s0.00
s 50.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
20L amps to 400 amps
-
$ 55.00
Over 600 amps or 1000 volts see uB'r above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E not included)
40.00
40. oo
20. oo
RECEIVED BY:
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