HomeMy WebLinkAboutPermit Electrical 1997-9-3
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225 FIPTH STREET q .--3~'71 ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Ooto-NO'/ 'r~J:. VI /L1 6 ~
INSPECTION REQUEST: 726_3i(69or~~g"!'i!llur.~m ::ity Jab Number '-17 J ~ 7 J
OFFICE: 726-3759 ERMITSHAiL -
AUTHORIZE '3". E.((;6~EFWb SCHEDULE BELOV ~
1. LOCATION OF INSTALLATION COMME D UNDER THIS P,J:QUI RK
55/.c; fY),,/n .<;/.. , NCEOORfS-ASNew Rem!~~MJyl-Single or
1I1VYI80DAYP .f1~/j)~Jllb).y per dwelling unit. .,- ,.
LEGAL DESCRIPTION ERIOD, Service lnl!luded: .
II ():l .~3 Lfd-- 6330 (> , Items Cost Sum
JOB DESCRIPTION
/()<,/all C;eoJ(/f.y
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Soni trol Secur qy or Relocation:
Address P.O. Box 21009
Ci ty Euuene
Phone 461-5678
Supervisor License Number j(,.,xq IftC:T
Expiration Date //)-1-9'1
Constr Contr. Number 65149
Expiration Date 7-2000
Signature of Supervising Electrician
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Owners Name SU~I / IJt!7I7i<; /y}CC-'rdy
Address---55./..<) /YJain ,sf,
Ci ty 5YIn ',-,3 f:'I';d Phone '746, -/I..c;t,
r
OVNER INSTALLATION
The installation is being made on E.
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------1)'----------------------------
DATE: '7 ---_ '3 - c;7
RECEIPT #':().-i7 --t- /'. (. .
RECEIVED BY:n. r na Uc#--/Z 6
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
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
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
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
S 36.00
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