HomeMy WebLinkAboutPermit Electrical 1991-2-28
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
, INSPEClION REQUEST: : 726-3769
. 'OFFICE: 726-3759 .
. 6Jtiy ls. .
1. LOCATION OF INSTALLATION
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LEGAL DESCRIPTION I .' J.
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.
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ELECTRICAL PBRHI'r APPLICATION
City Job NUIIlber
3. . COMPLETE ~EB SCBBD~ BELOV
0/0151.../
A. New Residential-Single, or
Multi-Family per dwelling unit.
Service' Included:
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JOB DESCRIPTION
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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.
2. CONTRAClOR INSTALLATION ONLY
Electrical contractor>>~( e.M,
Address ~ S~ W'd tfl'y ,
Ci ty e o..L"i (.AJtZ Phone ~'-I'-I- ~
I
Supervisor License Number ~<f~-~)
Expiration Date 'J D -'1/
Constr Contr. Number ,!;}CJ~dF?OG
JO':-Cf/
, Expiration Date
Owners Signature:
Qfr1AU J(r ~-'
DA~i~- /J-.-;7c5. \-f I - - ,---
RECEIPT II: C:t:::..,)' t::1.:5(,q::::>
RECEIVED BY: ~ ---.:.:::.!J/:/ r.~.
. 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 icr
,Modular Dwelling
Service or Feeder :J.. '$ 35.00 ' '1J)
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 Relocation
200 amps'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps 'or. 1000 volts
D. Branch Circuits '
$ 35.00
$ 40.00
$ 80.00
see. Un"
above
Signature of Supervising Electrician
~ ~ 91fS'-:S .'
, ~'1F~S ALLATION 'l} ^ " ,...,
Na~Il JtfL~
Address ' '-l.:o ~ ~ .'
Ci t/O X')IJlO J Phone~'tW-=)
The instal~tion is being made on E.
property I own which is not intended
for sale, lease or rent.
New; Alteration or Extension Per Panel
One Circuit '.
Two to ten Circuits
Each Mdt'l ten or',
portion thereof .
,
I
$ 35.00 :?~.~
$ 50;00 _
$ 15.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or 'irrigation
'Sign/Outline Lighting
.SignalCircui t or'" , .
limited 'energy panel
. 5;
SUBTOTAL OF ABOVE
5% State Surcharge "
TOTAL
$ 36.,00
$ 36.00
$ 36.00
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