HomeMy WebLinkAboutPermit Electrical 1997-10-21
.
eI/
. 1~'1
. 'act as submit'r:d t'"":; t\1: ..
.he followmg pro] ot roquir3 s?...:.:il\~ I...; I'~ l.........
:zoning, and does n
approval., I A {
Zomng--b -
97477 O~l.\{l~l--cn
726-376<J - (\n!\
Authorized Slgnalure
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1. 'd~~\<>Qf~~~~~~n\\ liJAU/
,l.f;G~AE;iqp:,PTIO~" r.~ ~.
\f\O,').rP'\ J I JUUL Cn/d)
f. .
~OVWPT~~.lLM n 1)J.o2{fr
0/ r
Perm are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
7I~5fn~
ovner: Name ~l 11 0. . ~\ ~Of\ D.
Address..0t:f:\o..~ \. QA \).ocr ~~)\nto,
CitY---XJ.)qyJ\O Phone 4~~'?'N1h
01lNER I~TALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE~~---ID-:~il~-q-~-----------------
""-\"".11'! 11: d-.. '7 I. ~ ~
RECEIVED BY: ..a..u
ELECTRICAL PERMIT APPLICA.:.I~N
Cj ty Tg9- Number Qf\\:-\~
Temporary Services or Feeders
Installation, Alteration or Relocation
40
3. COMPLETE FEE SCHEDULE BE LOll
A..
Nev Residential-Single or
Multi-Family per dvelling
Service Included:
2. CONTRACTOR INSTALLATION ONLY .B.
Electrical contract"i:~~+;~f\'f\~( t\rl-
Address \9fl '{\m,,'\1ul~
CitY_Tt~Q~- ~one\O~~~
Supervisor LIcense Number '?JC\~~
\\),\.C\f"j
C\ \rAf")~
\ ,~S ,C\~
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular 'Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
C.
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
uni t.
Items
Cos t Sum
\
4-
$ 85..00 ffi
$ 15.00 laD
S 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40..00
I
$ 40.00
$ 55.00
$ 80.00
volts see "B"
a lJO'Ve
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAl.
$ 35.00
$ 2,00
not included)
$
$
$
$
IR~~~
. _ ::>.S'"
,...,L4_ ~\
40.00
40.00
20.00
36.00