HomeMy WebLinkAboutPermit Electrical 1992-07-16C'TV OF
1. LOCATION OF INSTALI.ATION
-7,1 rt A/t ? b r-a s 7
225 TIFTE STRBEf,
SPRTNGFTELD, oREGON 97477
INSPBCTI0N RBQIBSTI 726-3769
0FPTCE: 726-3759
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ELECTRICAL PERI{IT APPLICATION
City Job Nunber 72D?zrf
3. COHPLETE PEE SCHEDULE BELOIJ
A. Nev Residential-Single or
HuIti-FamiIy per dvelling unit.
Service fncluded:Items Cost Sum
1000 sq.ft. or less S 85.00
Each additional 500
sq. ft or portionthereof S 15.00
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder $ 40.00
B Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less 'i
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/voIts
Reconnect Only
fu o.'
c Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
Over 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see ilB[ above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
s 3s.00
JOB DESCN.IPTTON
C,4t+,r-re r rt €c tt fr L *nttce
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACf,OR INSTALLATION ONLY
Electrical Contractor C .t H tr/&*71-
Address ?%i') Tfrec> $r/t Pd
cityEqEEA/€pnone 3{2 45 / 5
Supervisor License Ndmber 5t ? S
Expiration Date ct L
constr contr. Number 7?c, -,2 5':l <-
Expiration Date )7 - 1o - ry
Signature of Supervising Electr EIN
,.1
Owners E ///zK
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$
s
$
s
Address
Ci ty
5,4rrt E
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permi tOIINER INSTALI,ATION
The installation is being made on
property I own which is not intended
for sa1e, Iease or rent.
Ovners Signature:
DATE:
Phone
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/outline Lighting-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
00
00
00
00
40.
40.
20.
36.
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RECEIVED BY:
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