HomeMy WebLinkAboutPermit Electrical 1990-11-29
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
,INSPEctION REQUEST: : 726-3769
'OFFICE: 726-3759
ELECTRICAL PERKIT APPLICATION
Ci ty . Job NUlllber a () 1 it zv
3. . COHPLETE \lEE SCBED1Jl.E BELOV
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1, LOCATION OF INSTALLATION
'/..iJ7 Sco1fs G/.~u#
A. New Residential-Single, or
Hulti-Family per dwelling unit.
Service Included:
~;ESqPTI~11-X 'L,-r ~~o
JOB DESquPTION '
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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. cONTRActOR INSTALLATION ONLY B.
Electrical Contractor tJ.er;+~rj.;dViO
u '
Address q( s;-~ uJ. a 4.0/
Phone 3'1'1- J~O
Ci ty F t..L"''' ~
,
Supervisor License Number _ 9'1:~-S
'.:
Expiration Date
lo-1/
Constr Contr. Number ~19- ,;J ffe!) C.
, Expiration Date /0- 9/
"
Signature of supervising,Electrician
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. OWER INSTALLATION
Name
Address
City
phone
The installation is being made on
property I own which is not intended
" for sale I lease or ren t.
Owners Signature:
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'DATE: I 1:2.q:-~tr--
RECEIPT I: J '*'Xt:;{T)
RECEIVED BY: Cf/l. JL~
)
. Items
1500 sq.ft. or less
Each additional 500
sq, ft or portion.
thereof
Each Hanuf'd Home or
Hodular Dwelling
Service, or Feeder, .
"
Cost
Sum
$ 85.00
$ 15.00
4.
. ~
'$ 35.00 1D
-
'Services or Feeders (10 Branch CircuiXs
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
$ 80;00
$130;00
$300.00
$ 35.00
....
c. Temporary Services,or Feeders '
Installation, .Alteration or R~l!lcation
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,"B" above
D. Branch Circuits
New; Alteration or Extension Per Panel
One Ci rcui t '.
Two to ten Circuits
Each Ac!d t '1 ten or" ,
po~tion thereof '
.
r $ 35.00 ~
$ ~O.PO
, $ 15.00
E. Miscellaneous (Service/feeder notincludei
-Each installation '
Pump or 'irrigation \.
'Sign/Outline Lighting
,SignalCircui t or'. , ,
limited 'energy pane~
, 5;
SUBTOTAL OF ABOVE
5% State Surcharge '.
TOTAL '
$ 36.,00
$ 36.00
$ 36.0~ ._
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