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HomeMy WebLinkAboutPermit Electrical 1997-5-14 ;41 . "'-. -. ~~or.i('.L:._~D~__ ____ 225" FIFTH STImET Ci;C(00'- L<!.-iJ SPRINGFIELD, OREGON 97477 fH' ,....l-'P''' r; ---i ,,_ 0 n INSPECTION REQUEST: 726_37'619"1v,"..-'.A .::>,g:f~."_._" . ,L.----Ci-t.y-Job Number OFFICE: 726-3759 1. LOCAT'f9N pr ):I.NS,!,ALLAT.J.ON . oeJ- ~ ~'t d/M! d?{, fit-. ! ~ I / P LEGAL DESCRIPTION I f' tJ~ Ol.P I:J, O~O?) JQB flESCW:.. PTIqN ? .1" k'jC-gl tJ!.f.JL ~ .. Permits are non-tra~sferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days.' ELECTRICAL PERMIT APPLICATION q~gft& 3. COMPLETE FEE SCHEDULE BELOY A. New Residential-Single or Multi-Family per dwelling un'i t . Service Included: Items Cost Sum 1000 sq.ft. or less I $ 85.00 15 trl) Each additional 500 sq. ft or portion A do. tJ> thereof $ 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 2. CONTRACTOR INSTALl.ATION ONLY B. Services or Feeders Installation, Alterations Electrical Contractor Allen Electric or Relocation: Address 12 SW 3rd St. Ci ty Madras Phone 475 - 2 1 39 Supervisor License Number 1006S Expiration Date 10-1-9~ Constr Contr. Number fl874S Expiration Date 9-4-911 . Signature of Supervising Electrician , Ye-&-~,_~~"--~ Owners Nant ~Ltrfg f\ Address~ . ~q~ \ ~() ~rvj City ~[}CJt~_~ Phone OWER \J&ALJ..ATION The installatioh is beirtg made on property I own which is not intended for sale, lease or rent. ' Owners Signature: DATE~----------~---"---5~ff-qJ-----;- RECEIPT i: ~ I {,>, ~ ~- \\fn RECEIVED BY: ~_, 0',..j ~ 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 volts $ 40,00 $ 55.00 $ 80.00 see "B" above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Ser~ice 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 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 1/61)0 . 5% State Surcharge ~,~6 ?]eJo --... ~- L/6 ff-ki. I ~tI. ffD ~