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HomeMy WebLinkAboutPermit Electrical 1991-12-19 225 FIITH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION 141~ ?~&, OA-1CMlE LEGAL DESCRIPTION JOB DESCRIPTION /C!>>?/. Et'.8r.-7 . S'<<--7fP"A"'J' Permits are non-transferable and expire if york is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor A1/~1YLI Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician . D. Owners Nanie&~~"7' ~h~ Address ?75"J,j ~.rt!";reVAl5- )1fJ, Ci ty /l~AVT J%,a Phone-2L/ - 2723 . O\INER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. ~vne~ Jgnatur;;; Y' ~Dh (~I_ /:AT~~-----1-----J2-- / ,~~-;---~----- RECEIPT #: -:< "'< ~ J RECEIVED BY: ~~ City Job Number 3. COMPLETE FEE SCHEDULE BELOV CJ//47#L . A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 sq. ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 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 Branch Circuits $ 40.00 ~~ $ 55.00 $ 80.00 see "B" above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Liniited Energy/Comm One Circuit Each Additional Circuit or with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 $ 2.00 not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~t2 "7 '2"..0 1/Z'D