HomeMy WebLinkAboutPermit Electrical 1998-4-17
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225 FIFTH STREET ^Zoni~-=- (,<6 -
SPRlNGFIEW, OREGON 9W~"-\ - \ -,- ^ Y'6
INSPECTION REQUEST: 72~h~Q?S1gnatureJ--\
OFFICE: 726-3759 AU .
3. COHPLETE FEE SCHEDULE BELOV
1. LOCAT~Of ~i~ALLATION
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,g;,GAhDE~CRlPTION ((!.It~idlfj)t: /1a10 )
l' JOri.;,)\4-?_ f03(';O .
JOB DESCRI~ION
. /AJurl': ('$(' LlF/. .
f~f31 Permi ts are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
L R Brabham, Jne
Electrical Contractor . . .
Address 68 West "Q" Street
City
Springfield Phone 747~6638
~
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovner~Signature:
DATE;-----------21;.l\1-xJl~------------
~"'.Li'i I: :JD~n. ~ .
RECEIVED BY :- ' I----T-o' \ ~.
-
ELECTRICAL PERKIT APPLlCA~O~ I
Ci~Y Job Number 0\ ~ (fti 02-
. A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
Hodular'Dvelling'
Service or Feeder
,B. Services or Feeders
Installation, Alterations
or Relocation:
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401^~s to 600 amps $100.00
.~~~'s to' 1000 amps $130.00
Supervisor License Number 14735 ~~e~, 0 amps/volts $300.00
10/01/98 __ o~~. ~~~'O~ ct Only $ 40.00
Expiration Date .~~' \~, ~v
~'v'" #'~. ~~orary Services or Feeders .
Constr Contr. Number 08699 ...r~' ~A~'?I __~~1i. ...",<;n'nstallation, Alteration or Relocation
~. ~',YJ~v ~'?r' .
Expiration Date \~,~~~~,.f}.~~. 200 amps"oT less $ 40.00
~~~~ ~- a 201 amps to 400 amps $ 55.00
Signature of supervising~El~~~' Over 401 to 600 amps $ 80.00
X ~~' Over 600 amps ~r 1000 volts see "B" above
ovne'r~ ZV/fmG'5 .6. JjJ' iSm-- D. Branch Circui ts "
Nev, Alteration or Extension Per Panel
Address~3R.4~ /1Y7~
City ~ Phone!/.5...t/-, tJ570
OVNER INSTALLATION
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
I
$ 35.00 35,00
$ 2.00
$ 40.00
$ 40.00
$ 20.00
$ 36.00
35,00
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