HomeMy WebLinkAboutPermit Electrical 1992-9-4
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ELECTRICAL PERMIT APPLIC1!lfIO I
97477 Thefof/owln (}f1
726-tJ$99, .nd~t;~fCCl.s submftled h Ci ty Job Number ~ct:'X
roval, fl<lI re 're spaciflo'1a~ho !Of/owlng -
Zo '''0 3. COMP\1It't FEE SCHEDULE BELO\!
1. LOCATION OF INSTALI4'Q . - '? .
,'50 Zr;: J/' f' . ~" L- A. ev Residential-Single or
".wiOIlZlldSlgna!u(e L-'6/ Mult~-Family per dvelling uni t.
LEGAL DESCl\IPTION , - Servlce Included:
~UI~ ~~,. ~. -- - Items
-( L VlotW.>U. U\
JOB_ gESCRIPTION # . ~ 1000 sq. ft. or less $ 85.00
~ ~, Each additional 500
v' sq. ft or portion
?ermits are non-transferable and expire thereof
if york is not started vi thin 180 days Each Manuf'd Home or
of issuance or if york is suspended for Modular Dvelling
180 days. Service or Feeder
B. Gervicp) or Feeders
~i1l~tion, Alterations or
Relocation:
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
2.
CONTRACTOR INSTALLATION ONLY
v
Supervisor License Number
Expiration Date
/0/1'2..
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps X
Over 1000 amps/volts
Reconnect Only
Cost
Sum
$ 15.00
$ 40.00
*
$ 50.00
$ 60.00
$100.00 cD
$130.00 7:?lJ.
$300.00
$ 40.00
Constr Contr. Number ~.513? Bii'
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
/0/'11..
Signature of Supervising Electrician
~~..
ovner's N~me.q) 0 ~ * It ) 0 Jj~
Address :saM N\f) l if'---, ,
City ~\fi , Phone=uJ.b/1U.\
O~ \rN~TALLATION
The 'installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
~~~~~==-~---~-~~,r~-~-~--~-------
RECEIn If :LA~ l \- -, .
RECEIVED BY: r /\~
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
(10,/
/(70
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
/3(2'ci2
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