HomeMy WebLinkAboutPermit Electrical 1992-9-21
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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_. roqlilr.i~~AL PERMIT APPLICATION
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''''<a(j-~ PLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
"L 1 5(1 c.? / y >o....-,/?; c. 7+ I D
LEGAL DESCRIPTION
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JOB DESCRIPTIONfI:,rS' <,.-
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Permits are non-transferable and expire
. if york is not started vi thin 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
A T'JT
Address IS ('.7 ( 7<"<-. f
Ci ty t:- .....<.L- ~
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Phone "1 '1 'Z- 1'3 I ')
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Supervisor License Number 'ilS-2 -:s Le-
Expiration Date
10-1-'1'<;
Constr Contr. Number s-f:!'7Y'-I
Expiration Date
'1- Z '7- 7 '?
Signature of Supervising Electrician
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Ovners Name (6" ~ ,.I ~ of f: '-' v....,J ~c.. k.
Address
Ci ty Phone '7 'f 7 .- I '1,0'(
OIlNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
~
Ovners Signature:
DATE: Q- 7-( -'( 2..- .
RECEIPT II: In ZJ:;:>J?
RECEIVED BY: ,1J~
A. Nev Re tial-Single or
Multi-Family p yelling unit.
Service Included:
Items Cos t
Sum
1000 sq.ft. or less'
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 85.00
$ 15.00
$ 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
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Ci.rcu i t
Each Additional
Circuit or vith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
'f. Limited Energy/Comm lC $ 36.00 ~
5_ SUBTOTAL OF ABOVE ;tb. <<70
5% State Surcharge {,<rU
TOTAL '2.'7.5<0
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