HomeMy WebLinkAboutPermit Electrical 2002-09-24Oct- la-O1 Ot :43P
22-i FIFTH STREET
SPRINCFIELD. OREGON 9?177
INSPECTION REQUEST: 116ai6,
oFFICE 726-37i9
I. LOCATION OF T TION
Aiitnorlzed signature
E LEC.TR]CAL PERJVI T APPLJCATION
Citl,Joh Numhcr 32 -o t
St
3. COIV{PLETE FEE SCF{EDL'LE BELCW
A. Nel' Rc.sldentiirl$ingle or
P-O1
_ $ l9.oo
$ i0.()u
_._$63.00_
'- $ 75.00 _
-_
$ 125.00 --.- sl63 o0 __ sr75 00 _
$ 50.00
-*- $50_00 _-
_ $69.00
--$lco oo _
LEGAL I)IONa010 o?80c)
JOB DES oN lollowingProi ecr as sb
iiPPrOval
Pernr i t.s il rc llori -ltitnsferable a nd eErotsng
rf *'ork is u(,1 stitrtcd ryithitr ISu days
ol issttirncc or if rlork ts
ItlO days.
Multi-Fumil.v pcr <lrlelling unit.
Sen icc lncluilcrt:
Itenrs Cost Strrn
the tollowing
lHH0 nQSt, or less $ lffJ (,0
Eactr addtional 500
therccI
;ubmitted has'
gire sPecific
2 CON]'RASTOR INSTALI-ATION ONLY
Illcctriqtl Contraclo 1 Alert tlectric
Address 7970 N. .2 th Street
Cir.r s l-n f ie1dp56 7 47 -2273
Srrpervisor License Nunrber 243-S
Expiration o*tu ]0#
Constr Contr. Nurnber L27 7 2
Expirarioo Darc_ 5-22-03
aturr: of Supcn'ising Ek:ctricitn
,B;
Ad ?o Gn 3/o
Citl'Phone 3q { -4t t,+t
OWNER INSTALLATION
The installatron is being rrrade on
properq l o*'n which is llot intclded
for sele, lease or rent.
Orrncrs Signature
0?-
liornc or
ing
Sen ice or Feer]er
B. Sen'iccs or Fcetlcrs
Instirl lltion, Altcrttions or
f nC. Rclocntion
2UJ anrps or less
2.1)l anrps to 400 amps
iOl anrps ro 6Ut) lrnpg
(riJl anrirs tc l0{10 anrps
Over lt)00 amPVvoits
Reccrurect Cnlv
C. femporarS. Scrvices or Feerler.s
Installation, Altcration or Rclocstion
,
2Cl0 anrps or less
201 a.'nps rc 400 amps
Over 401 to 500 amps
Ol.er 600 emps or 1000 lolis scc
"B" abc.re
D. Branch Circuits
Netv Alteration or Extension I)er Panei
Orte Circuit
Each Additional Crrcuit or *'ith
or Feeder Perrnit \t
E. l\{i.scellnneans
fiv
go
$43.00
_ s50.oo
-_ $5o,oo
__ s25.00
-_.
s45.00
Permit Inspccrion fec is S{5.0(t + SrrIIi
J. SUBTOT.{L OF ABOVE
i9zo Stltr Surcharge
8 %o Arlrnini-ttrative Fcc
TOTAL Sz 12