HomeMy WebLinkAboutPermit Electrical 1990-11-7
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225 FIFTH STREET
. SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1~ LOCATION OF INSTALLATION -L-
[1-17/ /1 " ~l: Z-?-, 2... 8,
LEGAL DESCRIPTION
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ELECTRICAL PERHrr APPLICATION
City ~ob Number~ J=) 7
3. COHPLETE FEE SCHEDULE BELOV .
A. New Residential-Single or
Hul ti-Family per dwelling uni to
.Service Included:
2. CONTRACTOR INSTALLATI9N ONLY B. Services or Feeders (10 Branch Circuits
n included). Installation, Alterations
Electrical Contractor 0; 11_<) f.(ec:fr t'e.. or Relocation:
Address ~ { 7 0 lA J. I /,tA 100 amps or less
. . /" . '0 (/7 135 ?101amps to 400 amps \
Ci ty z.. <..fee (;I.{.. Phone ..::, I.....J.... U 401 amps to 600 amps
v all\ - 601 amps to 1000 amps
Supervisor License Number -/~~~ Over 1000 amps/volts
f{_ CI/ Reconnect Only
Expiration Da'te (, 7
Constr Contr. Number ~()~ ~
,
Expiration Date 0( /0; /
u}7J !~_:11A.in~~. ~~...1, D.
-4 &' Branch Circuits
Owners Name" 'J I) f' b ~{ re-
Address lOti ~ /;1 Sf ,
Ci ty So r rd Phone.2.4 ,,-~
I .
OVNER INSTALLATION
JOB DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is. suspenped for
180 days.
1500 sq.ft. or less L/.
Each additional 500
sq. ft or portion
thereof .
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
Items Cost
'Sum
$ 85.00 340fJD
$ 15.00
$ 35.00
$ 35.00
$ 60.00
.$ 90.00 .
$130.00.
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
The installation is being made on
property .1 own which 'is not intended
for. sale, lease or rent. .
Owners Signature:
-------------------------
DATE:J.L:..} -9z>
RECEIPT t:-J'X70] .
RECEIVED BY: (1_,~ (')
200 amps or less $ 35.00
201 amps to 400 amps $40.00.
Over 401 to' 600 amps $ 80.00
Ov~r 600 amps ot:1000 volts see "B" above
New; ~lteration or Extension Per Panel
One Circuit
Two to ten Circuits
Each Addt'l ten or
portion thereof
5. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$..50.00
$ 15.00
$ 36.00
$ 36.00 -
$ 36.00
E. Miscellaneous (Service/feeder not included)
-Each installation .
Pump or irrigation
Sign/Outline Lighting'
Signal Circuit or
limited energy panel
3'-10.00
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