HomeMy WebLinkAboutPermit Electrical 1998-3-25 (2)
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, ,__,GUY\ ;ll.ECTRICAL PERMIT APPLICATION
9~".1' ;.,. J :W\ltit;;o _' E lFiHE WUl'I" if O~ O?
726-3769 St'ERtJI\I S\-l~LLE)(t'IR c:PMr\g~iNumber qf) 0 ,~7~
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~llIHORIIED ll':r; &~llliQrlBERSCHEDULE BELOV
1. LOCATION OF INSTALLATIOrt ENCEO OR IS 1'1
CiI"1'l.. 0 'I!:) N\Q(\)of' COtJItJI _ ~'/t'~R\Oijf'!W Residen tial-Single or
- ~N'/ 'IlV Y, Mul ti-Family per dvelling uni t.
'fGAj'D~~eR.IfrJO 2/1 ',Service Included: 'Items ,Cost
225 FIFTH STREET
SPRINGFIELD, .oREGON
INSPECTION REQUEST:
OFFICE: 726-3759
JOB DESCRIPTIO~~ '
(:::::,.\ Di"' "'" 'S"S
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 INSTAg.ATI9tl ONLY
.,;.- c.C), '(" \ -\- ~ "" \ U? ~~, ""
Electrical ContractODr ~~\or\-'~
Address 'V, () , 9,-:-,--.,::- n(!,. \\ '1..,
Cit,g::;(),i..,D~~ Phone (,...,<;()..-u,iJL\
~0l-~
Supervisor License Number (l.:l -1...\ l/ <.U2.
Expiration Date_ \'0 101 l"'l~
Constr Contr. Number \~ c;b, (~
Expiration Date \2>/ \.., \~"1
Signature of Supervising Electrician
Iv. ~ \J.-.-1-'
o:ners Name c,>JL~'("' wr-:,\(..t. ~ D. '
Address {~<: <\~,
Ci t~ ,\ \ <. f>01... Phon~l..\c;.-: ~(..., '1
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
, for sale, lease or rent.
Ovners Signature:
DATE~-~-~-l~Jft1~----~---~~-----~--
RECEIPT II! " ()).-'1,LU)<,
RECEIVED BY: 'X' fyJ j..A-/'-
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
,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
Sum
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
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
$ 40.00
$ 55.00
$ 80.00
see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
"
One Circuit $ 35.00
Each Additional
Circuit or with Service
or Feeder Permi t ,$ 2.00
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
not included)
(t.
$ 40.00
$ 40.00
$ 20.00 diHlO
$ 36.00
.20. 0 0
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