HomeMy WebLinkAboutPermit Electrical 1992-2-19
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225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD OREGON 97477 1h.foUowlngproJ0CI8Il&Ubmll!edh8llthe""'--- 0; 4-ffi
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INSPECTION REQUEST: 726-3768lprov31. 18q\l..,. . .:Ilo~ Job Number \ \
OFFICE: 726-3759
1. LOCAtION OF -.!N~TA
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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
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- ~,_.'- ." .-----
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
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