HomeMy WebLinkAboutPermit Electrical 1991-12-16
,/
225 FIPTII STREET
'SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: ,726-3759
1. ~~~ON~{\~T~ln.f\
~~5.0~0'3qclJ
\'.hiorf~0f~c?f' ~' , '
P~rmits a~non-transf~rabl~ 'and ~xpire
if work is not start~d within 180 days
of issuanc~ or if work is suspend~d for
180 dars.
2. CONTRACIOR INSTALLATION ONLY B.
Electrical contractor~#t/~
Address R. <:JS IA J /./J? rJdib, ,
, City ~j #,,/1 P , ,Phone 3 C/L/- j wo
, Supervisor License Numb~r q c1<:J- ,')
Expiration Date" jfJ/Q I
, Constr Contr. Numb~r .--)D -dRO ('
J 1)/0 I
,Expiration Date
,
ELECTRICAL PERMIT APPLICATION
Ci ty Job Numb~r C\. \ Cio<6 fl
3. COMPLETE FEE SCDEDULE BELOV
A. N~w Resid~ntial-Single or
Multi-Family per dw~lling unit.
S~rvic~ Includ~d:
1500 sq;ft. or less
Each additional 500
sq. ft or portion
ther~of
Each Manuf'd Home or
Modular Dw~lling
S~rvice or Fe~der
Items
Cost
Sum
$ 85.00
$ 15.00,
A $,35.0000
Services or Feeders (10 Branch Circuits
'included). Installation, Alterations
or,Relocation:
$35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
200 amps or less $ 35.00
201 amps to 400 amps, $ 40.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Signatur~'of Sup~rvising,EI~ctrician
~~~'
" ,I)hll\ I 1n-l - D. Branch Circuits
owne:s Name r:J~;PJl,I
Addr~Sf::llcr~ r j)'"U!~_~'lf~ ~ :::,c::::::tion or ExLon
,City , .N \ 0 .A'ho~eJo ~ ::...:.u..L>....), Two to ten Circuits
, . " - Each Addt'l ten or
,OVNER STALLATION portion thereof
The 'installation is being, made on
property, I ,own which is ,not,intended
for sale; lease or rent.
'vrs ,Signature~' ,
, ft-.. ~k.j ~
. ,-
- r.:>
DATE: /2-/,..<(-.&7,,-
, RECEIPT I: ?,~? <..I
RECEIVED BY: - //~ t
"F
Per Panel
$ 35.00 ~
$ 50.00
$ 15.00
E~ Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
, Signal Circui t or
limited energy panel
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 36.00
$ 36.00
$ 36.00
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