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HomeMy WebLinkAboutPermit Electrical 1992-8-10 SfI.UNGt:II!I.O ,,,e following project os submll1ed ~os the f ,a... zoning, and does not raqulre specIfic land u ~, approval. _ ~CTRICAL P'ERKIT APPLICATION Ci ty Job Number 9.2/ d ibf!, 225 FIITH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 Authorized Slg""3'le 1. LOCATION OF INSTALLATION ~ :? 5 5 t!I!f17'r .--:: / ,.:;, 1.A. J LEGAL DESCRIPTION /7&3 :2 7 24 z:ra-o JOB DESCRIPTION ::S(J, o/A-fS 1MJ>? #~ AdrK//li()? Permits are non-transferable and expire if ~ork is not started within 180 days of issuance or if ~ork is suspended for 180 days. 2~ CONTRACTOR INSTALLATION ONLY ('Electrical Contractor Al~.#~,' ~ 'Address ~,,-:(" /.AJ/2-.;tA c:- r City ~<' Phone (;<(,1b-6fP1"1 , Supervisor License Number '1'(/6 S' Expiration Date /1///")- Constr Contr. Number c::;.~/""7 ,(EXPiration Date 10/2 Y9L , 1;'""''lJj;I~~~'' ~ I O~ners Name ..JU 11'1 &U/AlJ Address ? J <:, S"c....U.l e:r 65vA) City ~p;t Phone ?-I/-~7<Jc, OllNER INSTALLATION The installation is being made on property I o~n ~hich is not intended for sale, lease or rent. O~ers Signature: ~~:~::-:~-----~~~~~2C----------- RECEIVED BY: ~~ O( lHieHEDULE BELOIl A. New Residential-Single or Multi-Family per dwelling unit. Service Included: It ems Cost Sum 1000 sq. ft. or less S 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular D~elling Service or Feeder $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less $ 50.00 201 amps to 400 amps' $ 60.00 401 amps to 600 amps $100.00 601 amps to lOOO amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 40.00, 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 D. Branch Circuits S 40.00 $ 55.00 $ 80.00 see "B" above New, Alteration or Extension Per Panel 3.:::-, <N> One Circu.i t .....-- $ 35.00 '" Each Additional Circuit or ~ith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 :~5c:>-.::l /,7S' "1r.. /$