HomeMy WebLinkAboutPermit Electrical 1996-3-26
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225 FIFTH STREET Dole 3/ 2UJ /~ ELE" CTRICAL PERMIT APPLI~CAT,. ",
SPRINGFIELD, OREGON 97477 I q I
INSPECTION REQUEST:- n6_1~b~zed Signature ~(J 6~ ~'j ~ob Number \ '
OFFICE: 726-3759 l'
3. COMPLETE FEE SCHEDULE BELOV
1.
LOCATION OF INSTALLATI~
;;L I 7 7 h tU.. ,ilJ?: ;/.
\~~lION ('rT7j)
JOB DESCRIpION, i7' /.
72PA1I1. D j) .€.. f Mer N7 ""--'
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 ~~~~~
Address (p:J..e, r: (., ~ Pi.
City Xbv1.~; ui Phone 1'11-;). c.t3
supeJ::::7[;cense Number 30'C;/S
Expiration Date /O/I/'?'!
, I
Constr Contr. Number f(7-:;..o7~
Expiration Date
11/6/01
I
Signa~/o~ supe,/~ing Electrician
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Owners Name L. fA; Ln},f)~,e-~
Address ::;) I 7 7 hei2-S1~ Cr.
City :;::p~!u'J Phone
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01lNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
D~TE~---------:-A---2:S~~~~
RECEIPT II: t1ttil- D-- \jV III
RECEIVED BY: A./ UcJ-/-
A.
Nev Residential-Single or
Multi-Family per dwelling unit.
Service Included:
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
. Reconnec t Only
Items Cos t
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' :or 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 nB" above
New, Alteration or Extension Per Panel
One Circui t l $ 35.00 ~ r ~
Each Additional
Circuit or vith Service
or Feeder Permi t --.3- $ 2.00 [, I/.::--
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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