HomeMy WebLinkAboutPermit Electrical 1993-11-3
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~~~
, - /
Address
Ci ty
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name ,)Y?~ ~~'~
Address '/'3'7~ h'7~,
Ci ty 5pA-b ~Phone 7t,!7- /~ C/ /
. /~'7S'7~
OIINER INSTALLA'i'lo'N
The installation is being made on
property I own which is not intended
for sale, lease or rent.
;Io'ner~ k/J
------------------------~---t----------
DATE: //-~.., ":3 ' ,
RECEIPT #: . ~7&:.'&'
RECEIVED BY: /~_ _' .'
-'r
SI-IIINGFII2LD
C~ Job Number t:;;4' / ~~
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
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
""H. *
Cost
Sum
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225 FIITH STREET '.~~~~
SPRINGFIELD, OREGON 97 4 7,~,~~. 1":;:' ,,'" \} \ \
INSPECTION REQUEST: ~J2~-3769' ~
OFFICE: 726-3759 v \,':~\' '\ ~
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1. LOCATION OF INSTALLATIO~' . M~'~ "
SI?9~ .~A-.'-f? ""-:P':.~;.""e."9-$
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LEGAL DESCRIPTION )<~\.
/")...1f)? -':J2-~~/~
JOB DESCRIPTION, 1000 sq.ft. or less
).A/r:'"'~ ^'~~. .~p---~Each additional.500
/" sq. ft or portIon
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manufrd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
$ 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
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Ci rcuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit I
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
,...-- $ 35. 00 ~ ~~
$
:2.-
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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