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HomeMy WebLinkAboutPermit Electrical 1992-2-19 ~1.11I""\.&f-Il;.LU tI, 225 FIFTH STREET ELECTRICAL PERMIT APPLICATION SPRINGFIELD OREGON 97477 1h.foUowlngproJ0CI8Il&Ubmll!edh8llthe""'--- 0; 4-ffi ' lonlnQ. and d.Daa not . . . ._~. INSPECTION REQUEST: 726-3768lprov31. 18q\l..,. . .:Ilo~ Job Number \ \ OFFICE: 726-3759 1. LOCAtION OF -.!N~TA '\ ~l ) -\- '\ ':'II..\- E FEE SCHEDULE BELOll LEGAL D~CRIPTION \\ \)~~'r1.q\ (Jqqrfj ~JOB D~S.?IT.. _",PTION 1\), r-t,;;-/1c;;nB \1000 sq.ft. or less II" N cQC\', rrl;:l(J:::r0L..tCL,):ach additional 500 sq. ft or portion Permits are non-transferable and expire thereof if work is not started within 180 days Each Manuf'd Home or of issuance or if york is suspended for Modular Dwelling 180 days. Service or Feeder 2. CONTRACTOR INSTALLATION ONLY B. Electrical Contractor \\F\U-e:S E1.rl Address lV-73:/L? _ \'\\tttD7-W ~\LO\k City ~tQ Phone BC\h~,-~ \~r\ \S \0 . \ . q'l Constr Contr. Number t~'2L\D Expiration Date \0' ?~D .qfL.. Supervisor License Number Expiration Date r :gf S pervising Electrician # ,c;;"'" - ~,_.'- ." .----- Ollners Name \(\(\ nQ\\ rt QI1'ffi \ 0 f) D. Address2D5~, \!i~~~~. Ci ty~ ~ ~\ ~~ Phone 14\ - 2.l'2. 3 \ OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: -------------~---~- ~ ----------- DATE: ",J. I. . _ .\. RECEIPT II: - . .'.~ ) RECEIVED BY: ~ 1-'iA~- ~Y- - Items Cost Sum ~ $ 85.00 W A $ 15.00 .30 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts _____ $300.00 Reconnect Only $ 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 Branch Circuits $ 40.00 $ 55.00 $ 80.00 volts see "B" above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm One Ci.rcui t 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 r9rf/Co -..-1(5.00 Cl-LT 5 . n()