HomeMy WebLinkAboutPermit Electrical 1992-2-6
SP'nING~IELD
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225 FIITH STREET I r U ~\Q\~CTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ed~~~"""'" q
INSPECTION REQUEST: 726-3769 ~e9f1J~ Ci ty Job Number /7../) II ~
OFFICE: 726-3759 .""......II(\~9'o (\0\1
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1. LOCATION OF INSTALLA..ij.,.,~~~.
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LEGAL DESCRIPTION ~e~ ~
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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 t~~~ S/~N
8-- A",",""~' &J>.
Address /2 I D 0A'''fA''l6M 12-".
City Ii-v~"""'''" 0(2.. Phone 4S '" - S5 "k.
Supervisor License Number ~ ~O S~
Expiration Date
/0 - /- q-z.
ential-Single or
i-Family per dwelling
ervice Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations or
Relocation:
,~
unit. ~.
.~r ...
Cost
Sum
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
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number f,,2-dfe> '1
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
/0-1-<<12-
Si~~u~~~ectrician
Owners Name
r=A41..~ PA-<:..f(-lc..
Address (7'0. 1$0')( /4/0;
Ci ty P"'Il..'fL.A/'JD. oIL.. Phone "J''1 2./4-
OIINER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:'
~ATE: C!lTO-~ q FA.-"--:~----------
RECEIPT II: ~. ~ r>- ::"A&J
RECEIVED B~l tll >-... _ .
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D. Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting X $ 40.00 ~
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
4D . 1>0
2.1110
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