HomeMy WebLinkAboutPermit Electrical 1991-10-15
2. CONTRACTOR INSTALLATION ONLY B. ,Services or Feeders
, 'Installation, Alterations or
Electrical Contractor P~/'4;/,~ Relocation:
Address ~ l I U ~ L-"',.... 't.- 200 amps or less
201 amps to 400 amps
City E~,. ' .., Phone (, ~~ -r; l.z I 401 amps to 600 amps
d 601 amps to 1000 amps
Supervisor License Number J. 7 / '1 ", Over 1000 amps/volts
Reconnect Only
225 ..un STREET
'SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
~OG RT-v&.~ Lf'rLL.5 f!.C?, A.
LEGAL DESCRIPTION
. r 1703~L{i3,-(()tJJy!JtJ "
JOB DES~!'TION~"'iIlSiZ\.ll~J, uJanVl
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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.
ExpiJ;ation Date
(v l'i J...
,..,.. -F59L.~~
.1;"""( {-, --:'
;1'o-(-1-a.-<-(-19 -7'Z--
Constr Contr. Number
Expiration Date
Signature of Supervis ng Electrician
1C~~.9 "
Owners Narfe It h V\e H"" -H SD '"
Address -S"~" f( ~"e.. tli' II 5 ~J ,
City C'/ 1",' Ad' A eNlone 7'f 7 - .Yi G
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for ~ale, lease or rent.
Owners Signature:
~~~;:--7Z>-=1~ -?,(7-----~~-------------
RECEIPT I: 7--l":;?s' ~
RECEIVED BY: f~ ~
3. COMPLETE PEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq.ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 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
$
$
$
see liB"
40.00
55.00
80.00
above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Ci.rcui t
Each Additional
'Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
E. Miscellaneous (Service/feeder not included)
~Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00 Y
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE ;;;.. O. v
5% State Surcharge I U 0
TOTAL ~ "'ill .'U.J