HomeMy WebLinkAboutPermit Electrical 1998-3-25 (2)
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approval.
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AA:: .,:~, .SIgne1ure~ -OJ Rr.TRTCAL PERMIT APPLICATION
9~i~~376NOT'CE: LE)(P\RE\f~\t~08l} Number!lj' tJOq<.(
, "THIS PERM" SH~L Ie:, NOI .
, UNt%R "T~~~"T FEE;' SCHEDULE BELO"
1. LOCATION, OF INSTALL('TION ~U"THOR\ZED NDONED FOR '
==\R<;::::: D', r:,,~"'d\ "OMMENCEDOfW?~~'W Residential-Single or
- DAY PERIOD.Mul t i-Family per d'Welling uni t,
!!to~~fffqon2/q ~NY 180 ' Service Included: Items Cost
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
J, OB DESCRIJ;:TION
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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 ,B.
Electrical Contractor~'(J\F'J", PIV\S
"""\<::>''1''''\ '" V6'O~"-'\'\-'>.J
Address Y.:), \t,-:)>c ':4J-.L\ \., .
Ci tf:F<--l \':=..,~, Phon~/-(-,L\)l \
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Supervisor License Number ~ _ell -'..:c.+.1ii...
,
Expira'tion Date\ t) /<Tl\)""\<?\
Constr Contr. Numbert~_5h/~
Expiration Date (() I \~ J "\51
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Signature of 'Supervising Electrician
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O'Wners Name G'0..C}..; _~ \--(~ \=\"Y'f"\.lL,
Address K< '\ \Mc( Ave.
Ci ty.<tt---L\':f~_. Phone~q~-/~b'l
OVNER INSTALLATION
The installation is being made on
property I o'Wn 'Which is not intended
for sale, lease or rent.
Ovners Signature:
D~~E~------~-l;l~~~-~--------------
RECEIPT #: I ,C,I-L<11..DV
RECEIVED BY: ~'fh I~ .
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'D'Welling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 am~s to-1000 amps
Over 1000 amps/volts
Reconnect Only
SiJm
$ 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' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
$ 40.00
$ 55.00
'$ 80.00
volts see "B'I above
0'
Ne'W, Alteration or Extension Per Panel
One Circuit
'Each Additional
Circuit or 'With Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
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
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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