HomeMy WebLinkAboutPermit Electrical 1991-6-20
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225 FIFTD STREET
,SPRINGFIELD, OREGON 97477
INSPECTION REQUEST:' 726-3769
OFFICE: ,726-3759
1~. LOCATION. OF ,INSTALLATIjlp J
. J.j 2/5' Nil IX Sf. .5 <2.i/c1 '
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ELECTRICAL PERKrr APPLICAnON V
City Job Number' ~ \ OleA:- . .
3. COHPLETE FEE SCHEDULE BELOV ' *
A., Nev Residential-Single or '
Hulti-Family per dvelling unit. .
Service Included:
LEGAL DESCRIPTION... . n /J.. ^
~~p.;.'rl._ 1'Jl\...--I/')y
J~B DESCRIPTION
.In., II l1rreeze.lJtJj /'tv/oj
Permits are non-transferable and expire
if york is not started vi thin 180 days
of issuance or if york is, suspended for
180 days.
Items
Cost
'Sum
1500 sq.ft. or less
Each additional 500
sq. ft or. portion
thereof
Each Hanuf'd Home or
Modular Dvelling
Service'or Feeder
$ 85.00
$15.00
$ 35.00 .
2. CONTRACTOR INSTALLAnON ONLY B..
Electrical contractorN;;'ev -\N~--r'~ (b
Addrm g7~r' CONQ~ #7 .
City 6.H~ t5-rJ-= Phone34-3 '5 so f
Supervisor License Number q ? f 5 (
, . Expiration Da'te Jo;:) / f / 93
bq ~ ~ q
,Expiration Date . fO/ I / Cf I
,Services or Feeders (10 Branch'Circuits
included). Installation, Alterations
or Relocation:
100'amps or less
101.amps to 400 amps,
401 amps to 600,amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 35.00
$60.00
. $ 90.00 .
$130.00
$300.00
$ 35.00
C. Temporary ~ervices or Feeders
Installation, Alteration or Relocation
Constr Contr. Number
200 amps or less $ 35.00
201 amps to 400 amps $ .40.00
Over 401 to'600,amps $ 80.00
Over 600 amps or'1000 volts see "B"'above
Si~ture ~ Supe71Sing Electrician
'n~It.~ _' .
V (),./
Ovners Name ~J
Address 4~ ~ ) ~ nml, 'Q>
City lbrtlo ~e
Vi ~lteration or'Extension Per Panel
One Circui t
Tvo to ten Circuits
Each Addt'l.ten or
portion thereof
$ 35.00
$,50.00
$ 15.00
OWER INSTALLAnON'
The installation is being made on
property ,I ovn vhich is not intended
for, sale, lease or rent. .
E. Miscellaneous (Service/feeder not included)
-Each installation ,
Pump or irrigation $ 36.00
, Sign/Outline Lighting~ $,36.00, .?C...
. Signal Circuit or . '
limited energy panel . $ 36.00
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Owners Signature:
5. SUBTOTAL OF,ABOVE
5% S ta te Surcharge .
TOTAL
DATE: 6~:2.?-'7 /'
"",.....1M' I: "'2t:>~~L/
RECEIVED BY: _/"'7 ~z::-' ~ ~
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