HomeMy WebLinkAboutPermit Electrical 1997-10-10 (2)
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225 FIrlifhSmEfinature rJ ~ "'~<<, {:> ~LECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 ~~ # (\~ r./ a
INSPECTION REQUEST: 726-3769 .B.~ ~t/f ~$:) <(City Job Number "7 j / /57
OFFICE: 726-3759 <<,-r-.~ ~"V
~ 1Y ~LETE FEE SCHEDULE BELOII
1. LOCATION OF INSTALWION ~. ~ <::,~ ~<<,((:. ~'f-
~/'::?6 .-c;;,r<;,(~A;A~~{J .n,'*' ~-0~ f0-1p. ~ew ~esid7ntial-single.or
(/ - ~v <?V ~<<,v 0 if)\1!ul tl-Famlly per dwelhng uni t.
LEGAL DESCRIPTION "'~<::, ~()<(' ~v~ ~<<,<(' Service Included:
\{:\ .'<<""",,~ Items Cost Sum
r ~'- r;;:;v
JOB DESCj.IPTION va.s\ ,'8
IUu~ -AouS c:- ~~ uA-"'rV
v
Permi ts are non-transferab.le .and expire
if work is not started within 180 days
. of issuance or if work is suspended for
180 days.
2. CONTRACfOR INSTALLATION ONLY .B.
Electrical Contractor.1f\'~\1~j~~
Address PD. &'l. 1~3.;l3
Ci ty go l~ V'n ,Phone .fx:2.,-/1R/i-J./8'1Q
Supervisor License Number 2:{ :?,,? -;0,_
Expiration Date J()-I -qg
Constr Contr. Number ()~o5q3
1000 sq.ft. or less ) $ 85.00
Each additional 500
sq. ft or portion /
thereof $ 15.00
Each Hanuf'd Home. or
HodularDllelling
Service or Feeder $ 40.00
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
Expiration Date
;;'-/~-qq
Signature of Supervising Electrician
~L~#c?2A6/
Owners Name~' \1"HD\"vu~ ~
Address 'RCI s. ~ciflc fhJ.llA LB.() rsnx LJSl
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City YV11ll'1vuau:1-h Phone .t:)()?-,-R~'iS-OOCjIo
OYNER INSTALLATION
The.installation is being made on
property I own which is not intended
for sale, lease or rent,
Ovners Signature:
---------------------------------------
DATE: Ib -/0 - '7 7
RECEIPT 11: ;}7&4- '7
b"~"T,,,.,n tJv. K'w
200 amps'.crr less.
201 amps to 400 amps
Over 401 to 600 amps
. Over 600.amps or 1000. volts
D.
Branch Circui ts
$ 40.00
$ 55.00
$ 80.00
see.~ uBu above
"
New, Alteration or Extension Per Panel
One Circu1 t
Each Addi tional
Circuit or with Service
or Feeder Permit
S 35.00
$ 2.00
no t included)
Miscellaneous (Service/feeder
-Each installation
. Pump or i rriga t ion.
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
'I'O'l'A1.
$ 40.00
$ 40.00
$ 20.00
S 36.00
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