HomeMy WebLinkAboutPermit Electrical 1991-11-14
225 FIFTH STREET
'SPRINGFIELD, OREGON 97477
,.INSPECTION REQUEST: ,726-3769
OFFICE: .726-3759
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1. .I,Oftf~'~IN~~OD(1\~A.
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. JOIl PBSCR!JPTION ?J\' . '
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Permits are' non-transfera"\ 'and expire
if work is not started wit~n 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Elect~ical contractor~~~. ~/~
Address F50 aJ/..-IJ ~L/f'.,
. ,City~" 'Ph~nej'(/q-'-/:i?JO
Supervisor License Number CJLj)' - C) -)
Expiration Date ) t) /q I
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ELECTRICAL PERMIT APPLICATION'
Ci ty Job Number ,q, ()Lo ~ ~
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COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
. Multi-Family per dwelling unit.
Service Included:,
Items Cost Sum
1500 sq;ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00.
Each Manuf'd Home or
Modular Dwelling ~ 'JD.
Service or Feeder $ 35.00
Services or Feeders (10 Branch Circuits
'included). Installation, Alterations
or. Relocation:
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
'Constr Contr. Number dD - c2J/) r.
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C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Signature of Supervising,Electrician
. '~.~--
/ . n (\ D. Branch Cli-cui ts.
. owners' Na lJCI ~
. ',. ....11 n 'f'..- \ -.r.r~' New,AlterationorExtensionPerPanel
Address \ V\ I \ ~Q ,\ l '
,... .~' , njIlQ...' t _0(;- \'72 One Circuit . -L $ 35.00 ~
. City' . ' , y' Il :.. Phone\D~~'&.--J, ,Two .to ten Circuits ,$ 50.00
. .' .' . ' Each Add t' 1 ten or
. OVNER'IN ALLATION . . . portion thereof . $ 15.00
The 'installation is being, made on
property. I .own which is .not,intended
. for' sale; lease or .rent.
Ovners Signature:'
DATE:~ \- \ "-\--L-\. \
. Rt.".u,.. .: \..............
RECEIVED BY: l_.I'-, ~---
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E~ Miscellaneous (Service/feeder not included)
-Each 'installation
Pump or irrigation
Sign/Outline Lighting
. Signal Circuit or
limited energy. panel
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 36.00
$ 36.00 '
$ 36.00
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