HomeMy WebLinkAboutPermit Electrical 1993-12-20
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225 FIFTH STREET ~~;~:'~:. ", ,- '~ 1"11 /) ELECTRICAL PERKIT APPLICATION
SPRINGFIELD, OREGON 97477 """"' ~~~- 07 11'2 \(\01,
INSPECTION REQUEST: 72,6-3769" "--, -- IJ-;:;re> --t.J City Job Number Y. J\ \
OFFICE: . 726-3759" \~:o ,ci~ .
1. LDl;It.TION 0~INSTALLAlI~~S:iP\~re_.)-)3,._._COKPL:tar. nE SCHEDULE BELOV
10\ SD U'D.. rI\ ,<:orl\Al.5T: A. New Residen tial-Single or
Multi~Family per dwelling unit.
Service Included:
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, JOB DESCIp;PTION." n
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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
Electrical Contractor myF~~'(\(1.l\\
Address "3 f'Jil<)' PCY\Sc::rI'c t ,f<.d'
CitY~'LJ)~ Phonrq1;f....t'3b Ie
Supervisor a1cen,se Number ~ll;l..3 S
Expiration Date /y"q"
Constr Contr. Number' l.Ji.n- :3"3/ ~
Expiration Date II ) q4
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
S~~~~~~iSing Electrician
.. Owners Name ~~~(lG-o.0)r~N'
, V
Address I ;20D D;-CI,~f0'
Ci ty ~Dc\ Phone
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE~--------~-~\1-~~~;~~------
RECEIPT II: ,~=<p \ _' _ ) I '
RECEIvED B0',\\,I,{"';' 'V
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u volts
D., Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
One Circui t
Each Addi tional
Circuit or with Servi~
or Feeder Permit ~
Extension Per Panel
$ 35.00 ,~S pO
$ 2.00 I D,cP
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting'
Limited Energy/Res
Limited Energy/Comm
New, Alteration or
E.
5.
SUBTOTAL OF ABOVE
5% 'State Surcharge
TOTAL '
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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