HomeMy WebLinkAboutPermit Electrical 1991-2-26 (2)
1
ELECTRICAL PERHIT APPLICATION
, City Job Number , q"OOqz....
225 FIFTH .)....,..,..
'SPRINGFIBLD, OREGON 97477
',INSPBCTION REQUEST: ,726-3769
OFFICE: ,'726-3759
'1. LO~~ OF J!f~TALLATION, -1\.,
, L5Uo....t }Jl ~ ~C \J
3. COHPLETE FBB SCDEDULB BELOV
A. New'Residential-Single or
, Hulti-Family per dwelling unit.
Service Included:
LEGAL DBSCRIPTION
Items Cost Sum
1500 sq;ft. or less I $ 85.00 85
Each additional 500
sq.ft or portion jt J1J
thereof $ 15.00,
Each Manuf'd Home or
Hodular Dwelling,
Service or Feeder $ 35.00
, " JOB ~SCRIP'q,ON
~ c:::- \'0 flrrto [lflo ~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 dllys.
Services or Feeders (10 Branch'Circuits
included). Installation, Alterations
or Relocation:
2. CONTRACTOR INSTALLA~ON ONLY B.
Electrical contrac;olf~0i.Q O~C0l&
Address"1 Glib?> f!\v. ,~(\,^()OL Gel)
CityJ' ('J,\()i ~Ph~ne q42.>~lo lL
, Supervisor License Number ~ ~'
", Expiration Date' '(011 jql
, ,
'Constr Contr. Number ~''6 '63 LiJ
$ 35.00,
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601'amps to 1000 amps
Over 1000 amps/volts
Reconnec t Only .
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to 600 amps' $ 80.00
Over 600 amps or 1000 volts see "B" above
Expiration Date
s~ure'of Sup~vising Electrician
~~~.l:\~ "
, , ' " O:...h, .. '\'\, ,l~, Ul, ,1\ D~/Branch Circuits
.owners Na,me Cll)\ J* \J6lflTI \.~__ ,Ci.[f -ev: ,
" " "ilr.q- -":Z. 1Y\~.lL '\' ' ,New, Alteration or'Extension Per
Address C:ll'--\ u \ \ IlL.'{ a \ \ \ ) , ' ,
',' C' : "48 ' ' One Circuit '
City (jYl~' Q---,' Phone ~.,~17 to ' ,Two to ten Circuits ..
, " , ' Each Addt'l ten or
, ,OVNER I STALLATION portion thereof
Panel
$ 35.00
$ 50.00
$'15.00
B~ Miscellaneous '(Service/feeder not included)'
-Each installation'
Pump or irrigation: '
Sign/Outline Lighting
, Signal Circuit or
limited,energy, panel'
The 'installation is being, made on
'property, I own which is ,not,intended
, for sale, lease or rent.
$ 36.00
$ 36.00
Owners Signature:'
$ 36.00,'
II~pO
'-e>;r)
IQ0,'c:::.....
-:
'DATE: ~[)c0.,. _' "
RECEIPT ~\\ L ~( '1 ~
RECEIVED DY: rv . J..J -. ' I
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL