HomeMy WebLinkAboutPermit Electrical 1991-11-7
SI-IIINGt'=IELU
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
/9 J? ~ /If c L?&>~e?k/ Gpr-T A.
LEGAL DESCRIPTION 17D'?fZ-7/807:,pc>
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JOB DESCRIPTION
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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
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
,
......
Signature of Supervising Electrician
Owners Name lAJ~ lLr a.. M I ~ ~ W\ cvVl
Address I q<{Lo Mc...-tvJvt V r! C:f
City 5f fjj . Phone '7 z.b -!3t.J. Z-
OllNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~;. -~ff;f?/. )
DATE: ;?~ ~ /99/
RECEIPT I: '~L-\ ?-
RECEIVED BY: ti,vvv n
3.
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or ~
Multi-Family per dwelling unit.' .'
Service Included: _
Items Cost ~ 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 $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 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 volts
$ 40.00
$ 55.00
$ 80.00
see "B"
above
D.
Branch,Circuits
New, Alteration or Extension Per Panel,
J6
$ 35,00 ::J6 p?J
,
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permi t ~ $
2.90 ?.lJD
E.
Miscellaneous" (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5.
:I,} .t')(j
, ,~c;-
:>.,<;l.'iI ("
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL