HomeMy WebLinkAboutPermit Electrical 1992-5-28 (2)
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225 FIFTH STREET OJ!. 008170; i'ts SlJ6f'11. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 _ . ?Onin ' r09I.Jire s~~cJ. h<'l$) 1/
INSPECTION REQUEST: 726';"LJv: 9 . . ,. . CifICiq.~~~~I.t~k,J.ob Number ct 7...1)702-
OFFICE. 726-3759 AlJu. 1J"0 ',.
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. Sign
1. LJ J"pCATION J90F . INST~l'I~ ;1,., tttl.Jro
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S..'IINGFIELD
OMPLETE FEE SCHEDULE BELOV
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New Residential-Single or
. ulti-Family per dwelling unit.
S~'~e Included: .
....
Items Cost
Sum
,
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hJOB . DESCRIPTION '."\ . .. / {),.. 11 .
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
'180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor Ajg.W~ y~
,
'Address ~..20'L 'W&&r i9~.
-city~~,t. Phone....f;,tb - 2-3"5
,
Sup~rvisor License Number ~2. 5
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
.. '
. , EXplratlon Date
J r; - 1-9z.--
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$'50.00
$ 60.00
$100~00
$130.00
$300.00
$ 40.00
Constr Contr. Number;2e> -IV$' c..
C. Temporary Services or Feeders ,
Installation, Alteration or Relocation
Expiration Date
/6-1 -77-..
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 "B" above
si~~pervis
owner: Na~e ~e.J "'s
~cl~~
Address Lfo % 0 C6Vv1. vv:-e..\rC ,~ '
Ci ty ~-FLd
Branch Circuits
New, Alteration or Extension Per Panel
'.
/
$ 35.00 ?Y7.CJO
Phone.
. One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 2.00
OVNER INSTALLATION
The installation is being made on
property I own which is not intended.
for sale, lease or rent.
Owners Signature:
Ew Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
~ATE: .13~~J1.-;~~----------~--------
RECEIPTi:. 111/5~
RECEIVED BY: f' .A. . n
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL '
$
$
$
$
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40.00
40.00
20.00
36.00