HomeMy WebLinkAboutPermit Electrical 1992-1-22
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SPJIINGFIELD __~
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225 FIITH STREET tt>~,j;.fF>
SPRINGFIELD, OREGON 97477 ~",;i~#;'i"
INSPECTION REQUEST: 726-3769 ~~~~~5ll
OFFICE: 726-3759 A~,'-~~
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Permits a~ :on-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
-180 days.
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ELECTRICAL PERMIT APPLICATION
Cit Job Number q \ \~l 0'1
E FEE SCHEDULE BELOII ~
' ew Residential-Single or
Multi-Family per dwelling unit:
Service Included:
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~;7/~~
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Address ,..;? '}X-? I':"/'.nk.e-/
Ci ty h//J.~/A'./ Phone .:.3(/?- 729'7
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Supervisor License Number ~.;?.s2o- '>
Expiration Date
//r92
,
Constr Contr. Number /72,;,2_
/t?~-7?__
Expiration Date
OIlNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~;~----1~~~~<-{~-~--------------
RECEIPT II: ~ld'nsn
RECEIVED BY: , r? ~
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:
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
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting--L--
Limited Energy/Res
Limited Energy/Comm
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
Signature of supe~sing Electrician
tJ~ ~~A _
/ j jJ' 'J/. /' -..., 1-~ - D. Branch Circui ts
O~rs Name-Y-l /J fY)Q/l...../ jL O(j).
Addres 9W rY1/(1 iJO E.xJew, Alteration or Extension Per Panel
c~~l~~~ne ~:~hC~~~~~~onal $ 35.00
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
$
2.00
not included)
$
$
$
$
4(\CL?
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4->S .
40.00
40.00
20.00
36.00
$..l