HomeMy WebLinkAboutPermit Electrical 1996-3-10
ple01s(
Be (ote
c..:,(t t2kl-er.5
~ o~-'\~ To
COlA st-. L./S "'1:.....-
1: 0.10. ~~ '1- G/77
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
97477
726-3769
1. LOCATION OF INSTAI.,l4VON 'j.,
~ ;l.i-:t .If I a.. lJV /c.IIVI '? f,
17b,.t,~~Jll!kr)()
JOB DESCRIPTION ,
/!Jew ,^eo.t~f , ;:J.. Sv-tcL,'e5, l,A{ov<l t50cf{" S.o ~L.i~
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
Address fv. 8t1X
City f~q\.o\.~
;)'rl';).6{
Phone t<63-'l)373
3~ J'I-5
/0- '7<(
Constr Contr. Number %'//0
~-~"6
Supervisor License Number
Expiration Date
Expiration Date
Signature of Supervising Electrician
M)A~A.~~
Owners Name_CtO I KDdr;,(
Address~__ '
City Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
"'......-
~~~~;~-:;s~t/-~~~~-~-----~------
RECEIVED BY: -'!-i-14')A-
ELECTRICAL PERMIT APPLICATION
Ci ty Job Nwnber$oo 7 L-J
;;:;;:;;;;;;~;~::;;:";, ..~
Service Included: ~
3.
A.
Items
1000 sq.ft. or less
Each additional 500
sq, ft or portion
thereof
Each Manuf'd Home or
Modular 'Dvelling
Service or Feeder
Cost
Sum
2. CONTRACTOR INSTALLATION ONLYB. Services or Feeders
n ,~_{I C{.....' Installati?n, Alterations
Electrical Contractorc'JC:oc.0 L.I<>t l~'11: '('It'' 0;. 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
$ 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
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Ci rcui t /
Each Additional
Circuit or vith serVice;
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5%' State Surcharge
37. Administrative Fee
TOTAL
$ 35.00
3S{)V
J.DO
$ 2.00
not included)
$
$
$
$
37#
~
40.00
40.00
20.00
36.00