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HomeMy WebLinkAboutPermit Electrical 1991-7-8 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECfION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION ....I'l S7S:S- fnl4-1 tV $ pta LEGAL DESCRIPTION JOB DESCRIPTION ALe, E,.e:n,dI\1S ":::. -n> RE. 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. CONTRACfOR INSTALLATION ONLY Electrical Contractor ~ ~_ Address P,O r B <7 {::LbG R' City S~ Phone ?:'QQ-7Go1 Supervisor License Number (~~S Expiration Date /0/0/;] Constr Contr. Number /O)??S- Expiration Date ?j;)7/q~ Signature of Supervising Electrician ^~~()~ Owners Name Address City Phone u......, INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~~~~=-~----I{b, Y' ,-- r' --~-- RECEIl''!: II: 1/, _ '-7<\ma J 1 RECEIVED BY: (I..:XI / ~'~ ___ ' \...-/ I -- 3. COHPLETE FEE SCHEDULE BELOV * New Residential-Single or_ ., Mul ti-Family per dwelling uni to ' , ' ' Service Included: Items Cost Sum A. 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'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 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100,00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 1 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts '10 ,Ut) $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits 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 $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL -2-'CJO 42-.-CJO