HomeMy WebLinkAboutPermit Electrical 1991-7-2
225 FIPTB STREET
'SPRINGFIELD, OREGON 97477
, INSPEcrION REQUEST: 726-3769
OPFICE: ,'726-3759
3.
1.I,O~R~ 0~bW '.^.
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" -l{ll!. DESPP:l'TIOf A <"I, <:' _ n, I
( ~"' \, P\ . r t,J ,\ 11., '-'( 0(LV.
'permi ts are non-tr1).erable 'and expire
if work is not sta~ within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRAClOR INSTALLATION ONLY B.
Electrical contractor~~~~;1I;/
Address R &")' ;j j~JP:jt/-!b, ,
, City ~ (J/ /l P Phone, 1'c/c;I-l')7Y)
, Supervisor License Number C}t../~ S
J()Jq)
'Constr Contr. Number ~/)-d.?O ;P.
I/) /en
Expiration Date
.Expiration Date
Signature 'of Supervising. Electrician
'~
, Owners Na, e '
Addr~ssJ19q \~ ,lO~.l
City-.f:J. Jr~. "Phone foRK cn~
, . OVNER INS1Au.ATION
The 'installation is being, made on
property, I ,own which is ,not intended
for'sale; lease or ,rent.
Owners Signature:'
DATE: '1 ~,fJ . C{ I _ ~~..... _
, RECEIPT I: '-, /1- /' ~JJ../""\
RECEIVED BY: (~IL' ) -
. -
,
ELEcrRICAL PERHIT APPLICATION
Ci ty Job Number '~\ (') l.o ~
COMPLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1500 sq;ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00,
Each Manuf'd Home or
Modular Dwelling ~ 't)
Service or Feeder $,35.00
Services or Feeders (10 8ranch Circuits
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
Reconnect Only
$ 35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps'
Over 600 amps or 1000 volts
$ 35.00
$ 40.00
$ 80.00
see "8" above
D. 8ranch Circuits
New, Alteration or Extension Per Panel
One Circuit
,Two ,to ten Circuits
Each Addt'l ten or
portion thereof
$ 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 OP ABOVE
5% State Surcharge
TOTAL
$ 36.00
$ 36.00
$ 36.00
'In.cO
u ,2$....L
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