HomeMy WebLinkAboutPermit Signage 1992-3-3
225 FIFTH STREET \
SPRINGFIELD, OREGON 97477 \ ~
INSPECTION REQUEST: 726-3769 \}'
OFFICE: 726-3759
1. ~~~~ I~(I\~~
\Jf?5~~~\ nOlou
Permits a non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days. ,
2. CO~CTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Signature:
X-~~~~~~--~~~-,----
DATE: ~ C~ .'--"1 - cgta.
RECEIPT I: '_ J /' ~ ~ Qb I" I
RECEIVED By:t.:::-J) I.Y J._ ~
l\
SI.,IINGr-ICLU
3. COMPLETE ,FEE SCHEDULE BELOV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items .Cost
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or l~ss
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
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
, N\ - V ~J)....Jl', D. Branch Circuits
Owners Namel \11 I 0, ~~ C ~
() Q'C>7V7' ~~~ ~N) ~ AI",."," 0< ""''''00 Po< Pood
Address-QT.x:J rl 11 ~CV\
~ I'd' (\ Y lone Circui t $ 35.00
CitYiL~\l Y 1\ ..~Phone Each Additional
- . Circui t or wi th Service
~~~~~?\~~~~nl\e~ E. M::C::::::o::r:::rvice/feede: n:~O~nc1Uded)
property I own Whi~-:~S not intended -Each installation
for sale, lease or rent. Pump or irrigation
Sign/Outline Lighting \
Limited Energy/Res
Limited Energy/Comm
$ 40.00
$ 55.00
$ 80.00
volts see "B"
above
"
$ 40.00
$ 40.00
$ 20.00
$ 36,00
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