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HomeMy WebLinkAboutPermit Electrical 1992-5-15 ..i~ ~ \O~O .' 225 FIITO STREET ,,"~\\l.,e ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ~~~~~~\C\~ (J n 1'\ \ J \ INSPECTION REQUEST: 726-3769 \t\.~~,(O"~ City Job Number 0\/.-1) O~f) OFFICE: 726-3759 _.",ci\e~\,.,o: . , 1. LOCW~..Q.F IN!!AIR:.t.~~~GO"" ~OHPLETE SCHEDULE BELOIl ""--l" , Ai, hI \'~ \ \' ,_il'~ J....f.,t.... _\0d Residential-Single or ~k. - - ~~' Multi-Family per dwelling unit. .U,! \\~~D~~ O(9~~\l'O Service Included: Items Cost ~ ~m (-.'.'-:':.' UOB DES:CR.l.PTION '- )q r \ ')\ ~'Q ) Permits are non-transferable and expire if work is not started within 180 days of issuance or if york is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor EU6l'1~()iU Address I1.D lYl0\1101! 5+ .P.o,&OX.:t3CJ1</ City l:.u c..Ul-f I t9 R Phone 341/ - ~I cJ .'t7<iOl- Supervisor License Number 3>11- S Expiration Date IV/I/'l'J.. Constr Contr. Number 0V{(-Q 0 L/ /5/1'2 Expiration Date The installation is being made on property I own which is not intended for sale, lease or rent. ;;;;;;~ture: }: oj. / ~~~::~:~-~:)~~~~~l~l~---- RECEIVED BY:\"'AU,U ... E~S"t:i-S - J - 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 ( $ 85.00 $ 15.00 $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 $0 C. Temporary Services or Feeders Installation, Alteration or Relocation Miscellaneous (Service/feeder -Each installation Pump Dr irrigation Sign/Outline Lightin2 Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL 200 amps or less 201 amps to 400 amps Signature of ~~~:n~ Electrician Over 401 to 600 amps ~ Over 600 amps or 1000 volts V' --- [)' D. Branch Ci rcui ts Owners Name ~~I; \',,....,~ '" V)\Q{'I ~\(Jl\ (\, ;t-",) ~, Alteration or Extension Per Panel Address .P. 0. p.,Q)'. ri.:.-:'_':.~ 9..~ \ (\)1.0~~ ~~~ One Circuit Ci ty Fu r. . ~ . Phone-..a:'" "57-1: Each Addi t ional o ~ Circuit or with Service 'OIlNER INSTALLATION or Feeder Permit $ 40.00 $ 55.00 $ 80.00 see "8" above $ 35,00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~D, {XJ J) SO , <:::";r<::'/'" )