HomeMy WebLinkAboutPermit Electrical 1995-8-3
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225 .FIFTH STREET . '
SPRINGFIELD, OREGON 97477
INSPECTION REOUEST: 726-3769
OFFICE: 726-3759
1. LOCATION~F dSTALLATION
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(7, fJ ~ 1)
D ' ) ~ Ci ty Job Number
3. COMPLETE FEE SCHEDULE BELOV
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A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
C. Temporary Services or ',Feeders ,
Constr Contr. Number '7 t. -p.7~ Installation"..Alterat/lon\ or ,R~location
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Expiration Date f - ').5--9>< 200 amps or/ less \",1 $ 40.00
. , l 201 amps to 400 amps $ 55.00
Signa ture of Supervising Electrician Over 401 ~,6 600 amps $ 80.00
'-(f!~J rt<.J~ :Mu,",I....P7xL Over 600 ;amps or 1000 volts see liB" above
· Owners Name ~t1Q{-t Q\)(\~-A(\6\~D. Branch C>ircuits
Address ~ ~: M. '\\)~ ~\. - New, ,jteration or Extension Per Panel
\.., One Circuit I $ 35.00 35
~4 Lh~(J.. EacJ0Addi tlonal,'
~~ Nircui t or wi th Servic~
~i or Feeder Permit ~
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited 'Energy/Comm
LEGAL/~~CRIPTION ',"^,',~ '_
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lKtOB~~:r^
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Serii~~ or Feeder
. '
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 QNLY B. Services or Feeders
IJ I ~ I (":/) '11-.' Installati~n, Alterations
Electrical Contractor /Do ~J n7t(/..v'c:.-f.fk~ ~ or RelocatIOn: '
.........-...._Addr::e.ss )-)<D
rL 11~ (, h \fr II II V'-L-
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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
City (-vCJ,-e'Y'-~ Phone b$1777~
I
Supervisor License N~mber ~ 97,- 5'
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Expiration bate '~/o- i-7~',
Ci ty. r l-n.~ n.Q.... Phone
OVNER ~TALLATION
The installatioriis beirig madebn
property I own which is not intended
for sale, lease or rent.
E.
Owners Signature:
DATE: S..-:::t... *?~
RECEIPT. .: /k <"' ,7;3
RECEIVED BY:' ~~
'7 '
5... SUBTOTAL OF ABOVE
5% State Surcharge
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..
Items Cost
Sum
$ 85.00
$ 15.00
$ 40.00
(
I
/ '
)
$ 50.00
$ 60.00
$100.00
$130.00 "
$300.001"
$ 40.00
I
,....}
,.)
/
$
\0
2.00
not inclllded)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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