HomeMy WebLinkAboutPermit Electrical 1991-9-13
--l!- 2-.e<2- ~ 1':\\1 <::.r $19/\1
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769:'
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
/.2 17 R Sr:
. A.
LEGAL)QESCRIPTION
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~. DESCft\Ii"">TIti.
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V, _1:;.. -
Permits are non-transferable and explre
if work is not started within 180 days
of issuance or if work is suspended for >(g,~.
180 days. .
2.
,"",'
CONTRACTOR INSTALLATION ONLY.'
~.V"'. .,
;.
Electrical Contractor~G'ey~vd g(ec.T..:.~
Addr~s~ ::l- 7 ~ 7 0/4.... l' 1(.. ~:2-' ....., ,.
Ci tySt)"/~ ./te..l J / 0( Phone '7L!I- 25"96
Supervisor License Number ~~&~'IL..
Expiration. Date
/6 -j-?'7-
Constr Contr. Numbe'i- SL/6,,9o~'
Expiration Date
/1-lq~9f
The installation is being made on
property I own which is. riot intended
for sale, lease or rent. '
OWners Signature:
----------Zf------------~--------------
'DATE: 'L~r3 Jt(. . .
RECEIPT i: 2..L1/(5 .
RECEIVED BY: (~
City Job Number ql 0770
3.
CO~PLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
i>
" ;f Items Cost Sum
,
1000 sq.ft. or less ~
Each additional 500
sq; ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85. op 3'-/0<00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
B.
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.
Tefuporary Services or Feeders
Installation, Alteration or Relocation
't~. ,
.,' .1i.:I
2QO "'amps
~
201 amps
Ove lJ,.i",10 1
Over 600
or less
to 400 amps
. to 600 amps
amps or 1000
Signature of Supervising Electrician
.,. _ ~ . ~"~,;J'''
::../1~ }..-\.~'.
d "or . D. Bran~h Cireui ts
Owners Name GC\ ~ ~~l:n_Q 9~_~ Nt)
"'2 -:l.. n (\ "" tN\ \r-: ,\ \. ~.~ New, Alteration or Extension Per Panel
Address ,--) ~ ) '-\ \ '\. X -" \ \\:.:JN~. G\.., _
~ n ~._ - . - n (",\ /l One Circuit
City ~l(~ Phone~2-\n. - '""'\, \J6\V Each Additional
\ - . Circuit,or with Service
OVNER INSTALLATION . . , or Feeder Permi t
$ 40.00
$ 55.00'
$ 80.00
volts see "B" above
~/
$ 35.00
,.~.....
$ 2~OO
.'
not included)
f)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
3<!o .00
./ -, ,Dc>
_ <~-,.oo
Miscellaneous (Service/feeder
~Each installation
Pump or irrigat10n
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/~omm
E.
5. 'SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL'