HomeMy WebLinkAboutPermit Electrical 1997-2-27
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97477 ~
726-3'169&. 71 q
Authorized Signaturo,
225 FIITH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTl;ONC;-AO
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JOB DESCRIPTION
1./ f1}f?7dP Sf'ClI.b:b./
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
ELECTRICAL PERMIT APPLICATION
Ci tJ;J9b Number 97030 r
*
0""-
3.
COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical Contractor Son it rol Secur i ty or Relocation:
\
Add,'ess P.O. Box 21009
Ci ty Euuene
Phone 461 - 5678
Supervisor Li cense Number /(089 Rl T
Expiration Date /1)- /- 99
Constr Cootr. Number 65149
Expiration Date ~ "-'. .. 7- ~
Signature of Supervising Electrician
~~~ .
Owners Name Grt'Ypry t'!off Inc
Address /IQ7'- (-niea/1A,/ Lo
/ .
Ci ty 7--Atf l"fl (...- Phone 747-6.4&'(;,
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or ren t.
Owners Signature:
~~~~~~;:~------~------------
RECEIPT #: . f~ Lf "':1/ / .
RECEIVED BY: f 0 /yP ('/)ugO
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
uni t.
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
S 60.00
$100.00
$130.00
$300.00
$ 40.00
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
D.
Branch Circuits
$ 40.00
S 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscel1aneoys (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
I
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
$ 2.00
not included)
S 40.00
$ 40.00
$ 20.00
S 36.00
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