HomeMy WebLinkAboutPermit Electrical 1994-12-2
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A. Nev Residential-Single or '
Multi-Family per dvelling unit:
Service Included: '
;(NC '~;r~N<l- ~ )JJ:JfltU- J1UtJ
~f1;~its are non-transf~rable and'eXPire~'IS
if work is not started'vithin 180 days 1
of issuance or if, work is suspended for
160 days.
The, followfng project as submitt d h '
zonmg and doe~ ,0 as thl)
approv~. ~ not reqUIre r.pecif!c land 1.!<;I .
225 FIFTH STREET IlJ. ,.- ELECTRICAL PEIUaT AP~LICA ~
,Sl'RINGFIELD, OREGON 97477 Zoning m..v
INSPECTION REQUE'ST: 726-37~21.-.12-_-Z-9 ~ - Ci ty Job NWlIber -
OFFICE: 726-3759 ,- _II .
Authorize,d Signnturo_Jl::l'<tOHPLETE FEE SCHEDULE BELOV
1. LOCATI F INSTALLATION
o.z.R9;Cj ( .:.- _
. . PTIllJ1l. ViAJ111UL-
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2. CONTRACTOR INSTALLATION ONLY B. Serviees or Feeders'
/ /I) d 111111_1. T. Installation, Alterations
Electrical Contraetod--'I'\ . r)K.trl/l?l11n~ or Relocation:
Address~8 W&~T "Qli~, ~ 200 amps or less
L ~ ,I fJ 2lJ 201 amps to 400 amps
City ~ P , Phone 1,7, wtP-;JD 401 amps to 600 amps
S 601 amps to 1000 amps
Super,visor License Number 1473 Over 1000 amps/vol ts
[' 0 { , {I.l 5 Reconnec t Only
Expiration Date "'
Constr Contr. Number (JXC,cIOJ
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Expiration Date
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Si~ S4[s6'Z
Own-ers Nafie lntilL 1/);;--
Address {I/(J, P7/)K-~4-~
CitY2~!nl.fl1Phone22JO ,SOft/-
OIlNER INSTALLATION (~~Lo~)
The installation is being made on
property I own vhich is not intended
for sale, lease or ~ent.
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Owners Signature:
-----------------i. ~=-----------
DATE: \'l...1. ~" . ....,'
MCEIP1 if: - VI ,,'r
RECEIVED BY: \ ~~~).U--
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereot
EaQh Manuf'd'Home or
Modular Dwelling
Service or Feeder
Items
Cost
Sum
S 85.00
$ 15.00
$ 40.00
/
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
So,60
C. Temporary Serviees or Feeders
Installation, Alteration Or Reloeation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u vOlts
D. Branch Circuits
$ 40.00
$ 55.00
S 60.00
see "B"
aoove
Nev, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
S 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
S 36.00
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