HomeMy WebLinkAboutPermit Electrical 1997-3-5
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726-3769 ~ '. ro_ IV I VI
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1/3L9CPXION OF INSTALLATION
, ~") O/!jmfu...- 51
LEG.AL DESCRIPTION L
)-'7 t)~ ;15 3 d.. 040D
ELECTRICAL PERMIT APPLICATION
~itv ;o~ Number c:j~l)~~(\
3. COMPLETE FEE SCHEDULE BELaI/
A, Nev Residential-Single or
Multi-Family per dvelling unit,
Service Included:
JOB DE\SCRIPTION-
IV},) ...YJ.,(/(.u...- -l
C/I2eu. ,"h
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
l80 days.
Items Cost
lOOO sq,ft, or less
Each, additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dvelling
Service or Feeder
2. CONTRACTOR INSTALLATION ONLY' ,B. Services,or Feeders
, /,oe Installation, Alterations
Electrical cont~act~~r,z~~~ ~~~ Relocation:
Address 7/6 S-.4' /j-~#/ (;., ',200 amps or less /
, ~ 201 amps to 400 amps
Ci ty' 'd. Phone "7<(7 ~s:-Y 401 amI's to, 600 amps
601 amps to lOOO amps'
Supervisor License Number "?7 -:?tJ .<:', Over: 1000 amps/volts
Reconn,ec t Only'
Expiration Date //J,-- q<;<"
Sum
$ 85,00
$ 15,00
$ 40,00
$ 50,00
$ 60,00
$100,00
$130,00
$300,00
$ 40.00
. '5"Q, t9
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr Conn, Number 77/)"'t;'"
Expiration Date /0- '1~
~~o~~'~ "o.",.,"?
~rs Name /6rZe.Sft I/DiZ Htt5::>
Address /355 O/:JoYI,PL G 5T
City ~t?~ Phone
OI/NER INSTALLATION
The installation is being made on,
property I ovn vhich is not intended
for sale, lease or rent.
Ovoers Signature:,
" " j)~~~~;7j=-,~:'-'2;7~-:-~~---'-:-~--.-~
RECEtt. II;) (-)j,G-j.'l~-X.' '
RECEIVED BY: /7. /YI A r.l1 ::-:'//Cf
D.
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or lOOO
Branch Circuits
$ 40,00
$ 55,00
$ 80,00
volts see liB" above
"
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit ~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
$
$
$
$
5:' SUBTOTAL OF 'ABOVE ',i)4, @J
,5% State Surcharge',," . ,,',<9<70,
" . ~~T~mini:sF,~~~i,~~,:f.~~,,:,:;:<;{:.~~: '
$ 35.00
$ 2,00
q, t57J
no t 'included)
40,00
40,00
20.00
36.00