HomeMy WebLinkAboutPermit Electrical 1992-1-2 (2)
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225 FIFTH STREET ~i,:e;rJ",~'\:i\'}.\'\' ELECTRICAL PERMIT APPLICATION
. SPRINGFIELD, OREGON 97477 ,~,;t (}~_::~~IO c\?\';'-'"
INSPECTION REQUEST: . 726-37~9~~~'~('P\-'" City Job Number 9 //&-:<'2.
OFFICE: 726-3759 _Cll,o\\O~~~6'C'jZ'> ",.----"""
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, 1-Q~ " o-lS/.\' 3. COMP r ~E SCHEDULE BELOV
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1.. LOCATION O! INSTALE1fJ:ION7}J'ii"~"~~6\
4~5~~) .#. . \/~/~) . New Residential-Single or
. 09-\G~ ~{\~ Multi-Family per dwelling uni t.
LEGAL DESCRI ION ~. Service Included:,
/?~t72-"3?J-'"3!fJ8~ 0/7 ~ ./ Items Cost Sum
JOB DESCRIPTION
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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
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Electrical contractorLf& p~g~.
Address p.O. tusL J4g~ .
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Ci tY~llAlit\lL~LPhone '141 -, ;1.~3 b
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Supervisor License Number I" ~ b S
Expi;-ation Date lo-I-C)',).......
Constr Contr. Number Og~*q
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Expiration Date
Signature of Supervising Electrician
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Owners Name ~IY\O } It J~
Adclr.s~:q 5.~ ~ L r~ '
CitY~~PhOne '14'7-Q'1'1'1
OllNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------~-----------
. DATE: I "'~.-=7 2.
.RECEIPT #: ~~ (
RECEIVED BY: ~ ~ '
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.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
$ 15.00
$ 40.00
B. . Services or Feeders
'Installation, Alterations or
Reloca tion:
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.orRelocation
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
New, Alteration or Extension Per Panel
I
. $ 35.00 35.00
One Ci.rcui t
Each Additional .
Circuit or with Service
or Feeder Permit ,
$
2.00
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E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limi ted Energy/Res $ 20.00
Li~ited Energy/Comm $36.00
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
.37..00
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