HomeMy WebLinkAboutPermit Electrical 1992-3-10
S...IINGFIELD
~
225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 'fhef~flowlngpro 9 ~-~
INSPECTION REQUEST: 7~6-3 ,':g,Onddoll&j:~:;~bmlltod.haslh~~b Number ..( 0 :;.> :> ..-/
OFFICE: 726-~5J, rvval. reePeci1iclanduse
I\\W \.tc1. for'q~ ,~ COMPLETE FEE SCHEDULE BELOI/
1. LOCAT~ OF INSTALLATf.9lg \J\'\ - *
/96tJ I j;.;~ . 'T - 1-( i?1.1lt:>. . -::JA. Ne.... Residential-Single or ..
..wmorlZed Signature <=:1 1.C~-'FjiiInilY ~er d....elling unit.
~<;A;L~ESCRIPTION 'I"V'"-.......A~ ~"- " oW a:1Uded:
\11 X""')~c:; \....~ l.A. r\1.. 1 ) Items Cost Sum
/
(\ JO.ll llESCRI,I'JIpN C' " .
Q)( Q k'X J~\U\ '- )"rAm /
Permi ts are n '~transferab~e' and; expire
if ....ork is no~tarted ....ithin 180 days
of issuance or if ....ork is suspended for
180 days.
. -0 - CONTRACTOR. INSTALLATION ONLY B.
Electrical c:oJltractod..-,~ .1?lQ. fH7/f/l1'11,1ivc...
Address(P~ tAl. "Q11?l-, Slilfl ,Die. 0l41l
Ci t6lD.~tD , Ph~ne 7 LtTlfl(P 3 Z
Supervisor License Number 3~qp\S
fD}J}~J--
$ 85.00
1000 sq.ft. or less
Each additional 500
'sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 15.00
$ 40.00
. Services or Feeders
Installation, Alterations or
Relocation:
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Expiration Date
Constr Contr. Number 1;(oQQ
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
1~-/Z.qd---
Expiration Date
$ 40.00
$ 55.00
$.80.00
volts see "B"
200 amps or less
201,amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Signature of Supervising Electrician
X~ dCAJ;-
O....ners Name 00\ l\~ ~ ~K. J ~
AddreSS_~ If)~ ~_nn.1\dl!0
City r;.~hOn~cQ~(IJ~?
OI/NER INQ.ALLATION .
above
I
Branch Circuits
Ne...., Alteration or Extension Per Panel
One Circuit _.."'--~ $ 35.00
Each Additional .-
Circuit or ....ith Service .
.. - '"
or Feeder Permit $ 2.00 :;.--
The .installation is being made on
property I o....n ....hich is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00 -"fI7~
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
Owners Signature:
"MCO
__ ' ;Z 0..0
_&2.qD..
5. SUBTOTAL OP ABOVE
5% State Surcharge
TOTAL
7-/0-5'2-
-;2.q.,z r",
-~A_
"1-: ~ \
DATE:
RECEIPT 11:
RECEIVED BY: