HomeMy WebLinkAboutPermit Electrical 1991-6-25
I
225 FIFTH STREET ELECTRICAL PERHIT APPLICATION
SPRINGFIELD, OREGON 97477-...,> ,..' -',~",:~h"\M~ n 11'''-fl j'
.INSPECTION REQUEST:726-~69 ,.,.roG~\)~"~lo.IIdlMty Job Number l LAY I
OFFICE: .726-3759 '. . ~
1. .,LOCATIONO~ INST~TION . 'lo' f\~cl3.
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.' JOB DESCRIPTION.
A c' J '
.2 aD IH")--o..-~d ~p..r (c "'_
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B.
Electrical ContractorgJ.~.,.,::..I.,,>I?_t
Address If!).,<,,,, // (
City AJ~.(f....,},((~.Phone '7<1C -c(o-iV
Supervisor License Number ~ ~7 c: .,
. .'
'.. Expiration Date
'Constr Contr. Number.t~oo';'
.Expiration Date
Signature'of Supervising. Electrician
A_~ LtJ,.xJ
. Owners Name. ~ (~.l-f1~ r~.
. Address'
City Phone
OVNER INSTALLATION
The.installation is being. made on
property I .own which. is not. intended
for sale, lease or rent.
Owners Signature:
DATE:_ en 'bl~'\ L _
. RECEIPT II: '~/rY'~-<"
RECEIVED BY: _ . _ ,_;--,
CqItPLETE FEE SCHEDULE BELOV *
si ntial-Single or
per dwelling unit.
Service Included:
Items Cost Sum
1500 sq;ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 35.00
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
C.
.....s 35.00
,./ $ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
LPU
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 Circuits
$ 35.00
$ 40.00
$ 80.00
see liB" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lightin~
. Signal Circui t or
limited energy. panel
One Circuit
. . Two. to ten Circui ts
Each Addt'l ten or
portion thereof
E;
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL .'
$ 35.00
$ 50.00
$ 15.00
not included)
$ 36.00
$ 36.00
$ 36.00
(cE) , CD
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