HomeMy WebLinkAboutPermit Electrical 1992-1-17
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225 FIFTH STREET ,--""",.).""'\,;~':'\lOO ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ~f1~'-'\-'.:cf~-"'"
INSPECTION REQUEST: 726-37~9."'''I'!j~,;:,''-'d\'.I''~ City Job Number q / / ~ p;~
OFFICE: 726-3759 "",a\-',. ",'~ ",' \<<
:."'<.:,.,::.' ~. COMPLETE FER SCHEDULE BELOI/
1. LOCATION OF INSTALLATION 7.~':1:":'-'fPf J~ ~
'7// ,/)AILOAt-E. \J_ ~.~ . ev ~esid~ntial-Single.or ,
_-"_r.\-/ r"d}:":'o. Multl-Famlly per dvelhng unIt.
LEGAL DESCRIPTION ',...::_'p~,,\.., Service Included:
J'70.'2.,,-22.-4~ !.'", Items Cost Sum
JOB DESCRIPTION
p...M/:1I'WAA.// ,Frut /y{A~MENr 1!17~k-X'
Permits are non-transferable and expire
if york is not started vithin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor~
Address ~/O WALLIS
CitY~6.
Phone~
Supervisor License Number -:Jo4/ 5
Expiration Date !r)/' jq2.
, ,
Constr Contr. Number "7~ 7~Z
Expiration Date
~/~/92.
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Owners Signature:
~~~~;----T~7~~-~~-------~-----
~__1.
RECEIPT ti: , ,-:;>'.:;?4' (
RECEIVED BY: v'~,
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
B.
Services or Feeders
Installation, Alterations or
Relocation:
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 40.00
$ 55.00
$ 80.00
see liB"
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signJ~e ofJupe;?s~ ,Elect:ian
ttcuL ~~
., D. Branch Circuits
Ovners Name!J.!C i1AJZ/e/t(hfIVI-v Aprs, /.;IIQ7E~
' . ~~~Nev, Alteration or Extension Per Panel
Address-11/ 5. W. ~~,.we .\'UJ'Jfi -qg;~O .
,
Ci ty pl':D(7'~ /1 <?72.Ilofhone :;1:74-A4dJ
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
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
v""
volts
above
$ 35.00
$
2.00
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
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
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