HomeMy WebLinkAboutPermit Electrical 1992-3-2
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225 FIFTH STREET ~1. <1(f~O~~. ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 974770",~o,>. req::t6",1tt.
INSPECTION REQUEST: 726-31 . ''>9 'b.A.c~"~/Jt Ci ty Job Number C') I J ~Ljq
OFFICE: 726-3759 ..q%""" O/~,>~fO/Io
~<\r, COKP~ ~ SCHEDULE BELOV
1. LOCATION OF INSTALLATION Pile/lit"
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LEGAL DESCRIPTION \1 C82.:23\ \bl
1&).. tot. /iAl;) ),/;'7" In 17 &;/?Iw/J/)A fJJ//}.S;::.z2
Nev Residential-Single or
Multi-Family per dvelling
rvice Included:
uni to
Items
Cost
Sum
1000 sq.ft. or less J. $ 65.00 no,OO
Each additional 500
sq. 'ft or portion q 15,00
thereof $ 15.00
Each Manuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
JOB DESCRIPTION
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Permits are non-transferable and expire
if york is not started vi thin 160 days
of issuance or if york is suspended for
160 days.
2. CONTRACTOR INSTALLATION ONLY
B. ,Services or Feeders
'Installation, Alterations or
Relocation:
Electrical Contractor ('./T.Y E J.EffJIQI e c....
Address 7'1::~/) Sow. 8'774
.2'12 - '1{..Io/f
Ci ty f'oI<lLkN'C) 08- Phone ,:{jt~- bo7k
Supervisor License Number :L~ - .;< S'~c:"
Expiration Date '7/1 i'r~
Constr Contr. Number l't!l7'tl:l.
Expiration Date 7/1/'iL
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 -L $ 40.00 o/'t7. ",eo
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 60.00
Over 600 amps or 1000 volts see "B" above
Signature of Supervising Electrician
/~ ____ f) ~ 35'12. S
"'" v-- /' A C'~. D.
Ovners Name \:1WC ~nO IC:::Il LUUq1.
Address ~ {) ~ f.4i
Ci ty ~ li\ 1I Phone '1 VA- 24ld2-
OIINER INSTALLATI~N
Branch Circuits
Nev, Alteration or Extension Per Panel
One Ci,rcui t
Each Addi t ional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
Ovners Signature:
2f35.&>o
/"1. 25
"29<3'. 2-S-
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
DATE: l' - <- -'?l'2..
RECEIPT #: --=5:if??
RECEIVED BY:/7~ .
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