HomeMy WebLinkAboutPermit Electrical 1992-02-19,OREGO'U
225 FIFTE STREEf,
SPRINGFIEIJ, OREGON 97477
INSPECTION REQUEST. 726-3769
OFPICE: 726-3759
1. LOCATION OF TNSTALI"ATION
IJGAL DESCRIPTION
-a
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONIRACf,OR INSTALI,ATION OT{LY
EIec t r i ca} Con t rac to r (4(zzz -aa €AZ
Address a
EIJCTRTCAL PERI{IT APPLICATION
Ci ty Job Number ?ZA ?
3. COHPLETE PEE SCEEDULE BELOS
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service fncluded:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.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_
0ver 1000 amps/volts
Reconnect Only
C. Temporary Services or Feeders
fnstallation, Alteration or Relocation
A
Sum
fi.to
ciry FZ4gerE Phonee3:F2?zz r
Supervisor License Number 3
Expiration Date
Constr Contr. Number
Expiration Date 1ZG 7=-
S ture of ising Electrician
0vners Name
Address \n
Ci ty Phone
OVNER
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
RECEIPT
200 amps or less $ 40.00
Over 401 to 600 amps _ $ 80.00
0ver 600 amps or 1000 volts see trBtr above
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
D. Branch Cireuits
Nev, Alteration or Extension Per Panel
one circuit I S 35.00 j€
Each Addi tional
Circuit or vith Service
or Feeder Permi t '( S 2. oO
-eE. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/OutIine Lighting-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OP ABOVE
5E State Surcharge
TOTAL
$ 40.00
$ 40.00
s 20.00
s 36.00
RECEIYED BY:
2 5 a-D