HomeMy WebLinkAboutPermit Electrical 1991-3-15
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
,INSPEClION REQUEST: : 726-3769
, 'OFFICE: 726-3759
1, ,LOCATION OF INSTALLATIOt}, 1 1
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LEGAL DESCRIPTION .. I
fYl d--O 1"1' --1A-X" '...d 1~
I
JOB DESCRIPTION 1'1 ../I- .
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Permits are non-transferable and expire
if work is not started within 180 days
,of issuance or if work is suspended for
180 days.
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2. CONTRAClOR INSTALLATION ONLY
El~ctrica1 contractortJ..od.Ml~ ~
Addressj 55' It,J, ,:) '{f}/ 6
City fJ.-w_", Phone 3'f1f- 1;;rD
tJ
Supervisor License Number q</5"-S
Expiration Date '/O-C)/
Constr Contr. Nu~ber ]()- ~Xo c..
'Expiration Date
10- "'}/ '
.-!!"ii
ELECTRICAL pBlUIlT APPLICATION
Ci ty Job NUlllber CU ()!) J '7
3. . COMPLETE \liB SCBBDtq.B BBLOV
A. New Residential-Single, or
Multi-Family per dwelling unit.
Service Included:
Sum
, Items Cost
1500 sq.ft. or less, ' $ 85.00
Each additional 500 ,
sq. ft or portion. '
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Servic~: or Feeder" ' ~ '$ 35.~0 1/6
B. 'Services or Feeders (10 Branch Circui,ts
included). Installation, Alterations
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
Reconnec t Only'
$ 35.00
$ 60.00
$ 80;00
$130:00
$300.00
$ 35.00
.... '
C. Temporary Services, or Feeders .'
Installation, ,Alteration or R~l!lcation
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 voLtl lee,.B"
Signature of Supervising Electrician
~~~~f 94~~ .
,
, ,OVNER INSTALLATION ' !j)
Narpe&n(Wff\ , y-l--nJL5..
Address 1\ C\ C\ \f\ \; (t r I' 11)
City TAJO] n.LPhone ~~<2;-q 1:;).3 ,
The installat)on is being made on E.
property I own which is not' intended
, for sale, lease or rent.
~ Signa~ure:
'.//1../1; ~
---~~~T' --
DATE: ~ ' \. '-'-1 _::x
RECEIPT i: ~" r -J 1':::1::::/ 1. ~
RECEIVED BY: ""C,\ ~~~
D. Branch Circuits
above
New; Alteration or 'Extension Per Panel
One Circuit "
Two to ten Circuits
Each A<\d t'l ten or' '
po~tion thereof '
.
~~
/ $ 35.00
$ 5,0. P9
$ 15.00
Miscellaneous (Service/feeder not includec'
-Each installation '
Pump or 'irrigation
'Sign/Outline Lightin~
,Signal ',Circuit or', "
limited'energy panel
, 5;
SUBTOTAL OF ABOVE
5% State Surcharge,
TOTAL '
$ 36.,00
$ 36.00 =
'$ 36.00
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