HomeMy WebLinkAboutPermit Electrical 1994-7-19
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9~ ~'f!W Signature
ELECTRICAL PERMIT APPLICATION
(;; L/- (J)3/
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
flf'I--
~1ty Job Number
3. COMPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATION
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LEGAL DESCRIpP:ON.
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A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Sum
Items Cost
$ 85.00
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
JOB DESCRIPTION
\ N. <,,:TAlL SE Cua \ -rY S:tg E' I'l'l
$ 15.00
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
1$0 days.
2. CONTRACTOR INSTALLATION ONLY
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
B.
Electrical Contractori.N"\8c1l06."7.sO E't,"c7t""I(,
...-t'$"l' f3'U I ' NC .
Address -2:3,'2. l..-.L <:;;:"1'11
City Ev<aF-N.':S Phone ~8~-4.q.<;lc.
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
Supervisor License Number \<:::; 2.,~J.LE-
Expiration Date k) / I {eel.:,
Constr Contr. Number /c'>-'t:7CCLf:
Expiration Date IoJ 1/'14-
Signatute oF'iu~envising Electrician
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Owners Name K'ADIO ~r.(
Address ~ oNe cAloJO( C F-Arrrr<<..
Ci ty FDa. 7 c...J::>IZ7H 1XPhone 8/7 (7). ?o~O
Temporary Services or'Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
see "Btf above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Branch Circuits
D.
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 2.00
OVNER INSTALLATION
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm ~ $ 36.00
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
3(.,. a0
I /'1.-)
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
---------------------0-- --------------
DATE: 7 ~5' '5'C;;?
RECEIPT II: ' (.' j "'?,1;:tJ
RECEIVED BY: -1 _ ~ .....
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