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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: