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HomeMy WebLinkAboutPermit Electrical 1991-7-2 'gnatur of super~i~ E~ectrician -'f.~~ ./ ~ ~~ D Branch Circuits Owner5'Na~e.....: Q..jl))/{A____'l . . Address ~~ S fY1) f){'py(nJ C/~ '''4' /L'7 ':21 One Circuit City--O. P one~~t?Each Additional . Circuit or with Service OVNER HSTALLATION or Feeder Permi t 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. ~CATION OF W'W*ATIOli _ \ ~ , '-\'\()() \ '\ '( \. ~~'m ) ~GAL DESCRIPTION . JOB DESCRIPTION '7'0,,,, '"D, ("tfv..~or.,f- 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 Electrical Contractor \t\AC\D Address ffiqa") \f'\\\\ \\(\fJ\CU Ci ty ~)~ \tj 'ph~ne .( Zhq<641 Supervisor License Number "3 '6foS lCJ. \ ,q'Z-- Expiration Date 'constr Contr. Number ~~ Expiration Date 6'2Co.Qv The installation is being made on E. property I own which is not intended for sale, lease or rent. Owners Signature: ~ATE~~~\G-cr;----:t--t~ S\ ,-. ------ 5. RECEIPT I: ~!i#iJ rA~ RECEIVED BY: '+. I L I ~ ------------ 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: It ems Cos t Sum 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 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 Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 '+() C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 $ 55.00 $ 80.00 see "Bn above volts New, Alteration or Extension Per Panel $ 35.00. . $ 2.00' Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 40.00 $ 40.00 $ 20.00 $ 36.00 40~ ~ .( ^-.J ~.or)