HomeMy WebLinkAboutPermit Electrical 1992-05-27C'TV OF OFEG
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225 FIFTE STREEI
SPRINGFIELD, ORBGON 97477
INSPBCTION REQI ESTz 726-37,69
oFPICE: 726-3759 .i.t ,
1. LOCATION OF INSTALI"ATION
ELBCTRICAL PERilIT APPLICATION
Ci ty Job Number 4 zpl6D)
COUPIATE PBE SCHEDULE BBLOV
New Residential-Single or
Hulti-Family per dwelling unit.
Service Included:
I tems ,Cos t
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
, [:un ,
DESCRIPTION
JOB DESCRTPTTON
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Permits are non-transferable and expirelf work is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. c0N13,ACf,0R TNSIALLATIoN oNLy
Sumo
B
Electrical Contractor
Address
0 f .\ 80onf,irn ,,,fto
cit Phone '1+l - ALSL
Supervisor cense Number tb86s
Expiration Date l0 - I -9 7-
Constr Contr. Number Mg+q
Expiration Date q'l-qL'
Signature of Supervislng Electrician
Address
Phone '146: a 319
200 amps or less I
20L amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect 0n1y
o
$ s0.00
$ 60.00
s100.00
$130.00
$300.00
s 40.00
5o. oo
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
0ver 600 amps or 1000 volts see rrBrr above/a,^na{ n/d--
ovners Hare ,$rru fuO-6
cit
OIINER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, Iease or rent.
Ovners Signature:
RECBIPI *: (
ottaz d, -L7 -zi Z-
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
one circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign,/Outline Light ing-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
5o. oo
A. {o
$ 40.00
s 40.00
s 20.00
s 36.00
RECBIVED BY:
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