HomeMy WebLinkAboutPermit Electrical 1993-5-4 (2)
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SPRINGFIELD
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225 FIFTH STREET ;, .
SPRINGFIE~, OREGON 97471., .. L~
INSPECTION 'REQUEST: 726-3769', f, ',' ~ ----
OFFICE: 72'6-3759 . r. ~,__~~~-'jJ
1. LOCATION OF INSTALLATIR~..:.;ri:~Gj Signa.ture
.!l..S:.3l/ ~T . A.
ELECTRICAL PERMIT APPLICATION
~
City 'Job Number
t9-:sd>5.8?
3.
i~ FEE SCHEDULE BELOV
-
LEGAL DESCRIPTION
/7-o'2-3:Z~ Oo/'~O~
r
New Residential-Single or
Multi-Family per'dwelling unit.
~ Service Included:
Items
Cost
Sum
JOB DESCRIPTION .
I~mu UeT lu-lo AIJl\ R..o~kc.h ~ltuA.\ T
.
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof .
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
.
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor~15On\ ~~~
Address~~ c..~ Lt>
Phone lD~ 11~ (-
$ 15.00
$ 40.00
B.
Services or Feeders
Installation, Alterations
or Relocation:
Expiration Date
Number :.J!Po 1 S
IO/c,I/9 r
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
Ci ty ~ " .,.....
'.)
Supervisor License
.r
.' .
Constr Contr. Number~:.':"
Expiration Date /0J/9'j
C.
Temporary Services or'Feeders
Installation, Alteration or Relocation
.
Signature of Supervising Electrician
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
./~ C3 f"~,
Owners N~.me S,EV'=t..) \-ht.~c. k,'
Address ~ '" ~Q
Ci ty ~\~ ~\.j Phone 14' 7~ lot.,.,.
OVNER INSTALLATION
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit I
Each Additional
Circuit or with Service
or Feeder Permit I
$ 35.00 . 5'S:~
$ .2.00 .
~
2.
The installation is being made on
property I own which is not intended
for sale, lease or re~t.
Owners Signature:
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
DATE:
RECEIPT I:
RECEIVED BY:
.y:Y-9~
$$6/
/7~_..-
.~,.-
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
~7~
I . ,,-
~x. ~~
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