HomeMy WebLinkAboutPermit Electrical 1992-6-4
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--'-'~~ ~.~;"",* 'lIIHiJ..Q.."'i/i\'a!;\ '1ELECTRICAL PERIIIT APPLICATION
~;~:,,~~~~~~~Q!.l;~~~~~~~Ob Number q~D4G\D
ZoO!nL~1.:..L
'. (n -4 -Ul'23-' COMPLETE FEE SCHEDULE BELOV
. __'_.__cl SlgnatureAG~w.-Re.sj.den,t,iabSingle or
Multi-Family per dwelling unit.
Service Included:
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
LO~ftTION OF INSTALLAT~N
l;id"10 Add/if.$..!-
LEGAL ~~IONt\3"D)
J1OO. - \ - . _
JOB D~CRIPTION
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- I
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. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~~
Address \)() '2:i>LIL181J
City ~~Ph~ne\4l. ~.?-A~
Supervisor License Number \\i)~~
\D. \ ,q~
Expiration Date
Gonstr Contr. Number (~
Expiration Date C\. \ .q~
Signature of Supervising Electrician
. ;?_# /?'7~
owne;s Nam, J) ~O}( ~ TI 1 f~
Addres~ 185 0. ) (',~#&
City P1JQlflO. Phone 1 ()9({n''lJ~
OIINER IN9rALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~-----1-()-~-~~-~~------------
RECEIPT II: - . II .4: ~PI
RECEIVED BY: ~q J~
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Items
Cost
Sum
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
B.
Services or Feeders
Installation, Alterations or
Relocation:
,ic
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
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
$ 40.00
$ 55.00
$ 80.00
see "B"
above
D.
Branch Circuits
New, Alteration or
Extension Per Panel
,r-
--L $ 35.00 'J j=----
One Ci'.rcui t
Each Additional
Circuit or with servicel()
or Feeder Permit --LJJ $
V'
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 S 36.00
5. SUBTOTAL OF ABOVE ...P5..t::).W
5% Sta te Surcharge . .!/.' I =:>
TOTAL =...., . -rs-
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