HomeMy WebLinkAboutPermit Electrical 1997-3-31
Authorized Signature '(\ h'\'ELE~R~ PERMIT APPLICATION
97477 O,,\CE~ \RE \riHE. 9r1 4
726-3769N. ~M\iSH~LLEXP p~\S~~umber l -1'1- b
. . . iWS pEl" ER iH\S ~
. r\OR\lEO \j~9 cg~~{1~2'SCHEDULE BELOY
1 ~ LOCATION OF INSTALLATION ~\ji CEO OR \S P\ . .
525 ~ i \ \ <3:,--;:--. GOMMEN '. ~\QID;w Residential-,Single or
~ ~BOU~'{ Multi-Family per dwelling unit.
d:AL l~~~';:,I~i70 ], ~ ~tl3lfl '1J () Servi ce Included: Items
JOB DESCRIPTION' 1000 sq.ft. or less
R{Sic.e;0T10~ ((e:-mone:L- Each additional 500
'. sq. ft or portion
Permits are non-transferable and expire thereof,
if work is not staiied within 180 days Each Manuf'd Home. or
of issuance or if work is suspended for Modular Dwelling
180 days. . . Ser~ice or Feeder
Zonlnp ()
Date ~...... '2,1 - ~ 1$
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number /673 fJS
,
Expiration Date
/o-qg
Constr Contr. Number
Expil-ation Date
. Signa~re of superv:sing Electrician
.r-IlrY4-(u~.(u,u " .
~ (ame S~.. f) (..,/,vVQ'-fj,tn!\ S~Jl/~ Ls _
, I.
Address 52....-::) In i /1 sZ-
Ci ty Sf~ 1Alrfil!lJ} Phone 7 'f'/-',] 'IS
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
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
C.
Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
,.
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation '
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit l
Each Additional
Circuit or with Service
or Feeder Permit cl-
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 35.00
3S{f)
2-()O
$ 2.00
not included)
$
$
$
$
~7,-O_D
J .X~
- 't. J-l
<~
40.00
40.00
20.00
36.00