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HomeMy WebLinkAboutPermit House Move 1991-1-17 ~t , I ,,~,;:::<::i;.?':';:.r:.:~. 225 FIFTH STREET 'SPRINGFIELD, OREGON 97477 . .INSPECTION REQUEST: .726-3769 OFFICE: . '726-3759 1. LOCATION OF INSTALLATION 7<;?7 ,;0,4/-+ .~..-// /-,. h LEGAL DESCRIPTION ~\JOB DESCl\IPTION \.- L . . \ 1..... N;: ~ ~ "b, \? \. 'YC-,\) ~ 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 Electrical Contractor' Address City . Phone Supervisor License Number -. Expiration Date . Constr Contr.' Number Expiration Date .Signature'of Supervising. Electrician ':,,", . Owners Name. :"aA" J!t,.~A f"bh . Address' . P ';t rtf''" r'/N,j..1.~ A"A /.< /])'..7 j .' C~ty JiY<. h . OVNER' INSTALLATION Phone The .instal1ation is being. made on property I .own which is not. intended . for sale, lease or rent. Owners Signature: . L-- -~ - '. DATE: V \C{, : \-_ V)-~ \ . RECEIPT I: ,-).r\tJ .('_ RECEIVED BY: B-:- -~ "'-, '> ~ --- I ELECTRICAL PERHIT APPLICATION city Job Number c\.. \ C'(jL\2) COMPLETE FEE SCHEDULE BELOV ". *. . .'. .'. ...:." A. New Residential-Single or .... - . Multi-Family per dwelling unit. . . .'. Service Included: '. .'.' ..' Items Cost Sum' 3. 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 B. 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 . '. . eX) ~$ 35.000'3: . $ 60.00 $ 90.00. $130.00 $300.00 $ 35.00 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 $ 35.00 $40.00 $ 80.00 see "B" above D. Branch Circuits New, Alteration or Extension Per Panel One Ci rcuit .Two .to ten Circuits Each' Addt'l ten or portion thereof $ 35.00 $ 50.00 $15.00 E; Miscellaneous (Service/feeder not included)' -Each 'installation Pump or irrigation Sign/Outline Lighting Signal Circuit or limited. energy. panel' $ 36.00 $ 36;00 . 5. $ 36.00 . 0'0 CO. \.. I,,) <'1' J.C:. \J~. V SUBTOTAL OF ABOVE 5% State Surcharge TOTAL