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HomeMy WebLinkAboutPermit Electrical 1991-11-15 225 FIFTH STREET 'SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION lll-\t~ IV1fii~ \-1-, LEGAL DESCRIPTION 110~""2-S4/' DI~O . JOB DESCRIPTION In/rv, "il1bA..aMd~'iLjllrdifl.L- 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(lj.,~ ~i1'IO .dJ(\~.. l' I Address~~ Cit~ Phone '74/-1,1.31:, Supervisor License Number r /"'!1 h S Expiration Date 10 -1-q!L Constr Contr'. Number O,:j~q Expiration Date Q _I - q I Signature of Supervising Electrician /2~C-)~ ~';;;;"ers Nanie~~1.' ~/~. u . I Add res s-Ll!:t..1 llllYl) ~t. Ci ty ~~ d Phone --2.!:L'7 - Z b q I OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: --------1--------- DATE: _ _ 11llf..jS ( RECEIPl II: ...;:( 11"'1 RECEIVED BY: l'1 A O.l'Jlv<M- S'-'IINCr-1ELD 3. , \ COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or \ Multi-Family per dwelling unit. Service Included: . Items Cost Sum 1000 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 $ 40.00 B. . Services or Feeders 'Installation, Alterations or Relocation: 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 $ 50.00 $ 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 $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits New, Alteration or Extension Per Panel J- $ 35.00 35'.00 One Ci.rcuit Each Additional Circuit or with Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) ~Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limi ted Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ~~.DO I . '1 '5' .=lh. '1:;' 6\'1 C\\ \~