HomeMy WebLinkAboutPermit Electrical 1997-11-12
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t>-\.l,,,,O~I'lC'C.O O~ IS ~CTRICAL PERMIT APPLICATION97 0'10 (p
COW.W.'C.~ c.P.IOO. /J "1-1+-1-1
a" O~~ ? Ci ty Job Number '0:'( / I~- .
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3. COMPLETE FEE SCHEDULE BELOII '*
1. LO~TION 9..F_ INSTALLA*N /; /!)
{al ":1'9 /rj?~,/' '/ . A. New ~esid.:mtial-Single.or. ..
Multl-Famlly per dwelllng unlt.
/ ..9E.l'.AL W:~NI:T)ON l1'\ <r' . Service Included:
_J..Y7-4...B.f..,."'\~ - U.)O(J . Items Cost Sum
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
JOB DESCRIPTION
Permits are non-transferable and expire
if work is not started within 1BO days
of issuance or if work is suspended for
1BO days.
2. CONTRACTOR INSTALLATION ONLY
. !
Electrical Contractor!?; lTer ;:::hr.' The,
, .
Addressf03;;l-1 ,\pa,rt:; [?d-
Ci tlb /f.t>>J p r.:l-O,", e Phonf!,~ t./I- tJ'I/- (J) kS-
Supervisor License Number IS D if.. s
Expiration Date
10- 0 I -c;?
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Contr. Number 73.>/~
Expiration Date (g i I?, /91
Signature of Supervising Electrician
~j)j)Ji), fB/h;o-z..
Owners Name (')oc (.;yeel"
Address_7 95;;"1 1J/;);oTT JI;// Lh'
Ci tyrO 7!tl7l!-- _6Pc/e Phone qLj 2 -1 )g(
OIlNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
\
\
,
/
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DATE: II , /1... q"l-
RECEIPT 11: . t J.1 - /Cf Y, 'In
RECEIVED BY: \.[. vr JiJ'v--.--
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
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D. Branch Circuits
$ 85.00
$ 15.00
$ 40.00
$ 50.00 50,OD
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
volts see "Btt
above
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Servi~
or Feeder Permi t ...al...- $
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
-3% Administrative Fee
TOTAL
$ 35.00
~ _.L~ nJ~
:.F
2.00
>>
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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