HomeMy WebLinkAboutPermit Electrical 1993-4-2
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225 FIFTH STREET '. '" ",'" '. ,:;'" .,": ']'10';1,'" . ELECTRICAL P'ERHIT APPLICAftN
SPRINGFIELD, OREGON 97477N0 '':)n:...,)~., "';""".:;,' '~'I, ~O I
INSPECTION REQUEST: 72'~if.3769S. Z" ,'. ")~/}fh:9;~..i ty. Job Number '-10 .
:~FI:~~::-::5:NSTA~:US'S::~' ~~COHP":;;f~E SCHEDULE, BELOV
01 t:-I ( 9'\ sJ\ ,,-~.iJ f 1lA A. ~e" ~esid~nlial-Single. or .
. MultI-FamIly per dwellIng unIt.
l<}(n~~m!J:r) (7)1... fin ser'v~~ Included: 'Items Cost
~JOB DES~PT.!..O.N,..j ^ ".....
,--) ~ t-"O~ \~Q
_AO?'} l? 1000 sq. ft. or less
)~ I Each additional 500
sq.ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
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
Electrical contractor~
Address~Yl0 {A_} \\~~
City Yl ~ 0 Phone { ~'1- t gSI
supe~~sor b)~e~s: Number q)<(15
Expiration Date \ () I \. ~~
Constr Contr. Number c!) I\.~c) I
Expiration Date 4. 291. q~
. Signature .~2f~~sing Ie trician
~V(V ..
./
OT,.1ners Name \ t\ 0 M 0 I\r) .
AddreR)O \ l ~ l QpJ\~
City ~_6.- Phonel'tl, XI(J-
owd iJSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
~~~;~-----~~-;,~-~q3---=---.~--
RECEIPT i:- \ J- -- ) , t~
RECEIVED DY: c:J) \)j R /' -
B.
Services or Feeders
Installation, Alteratibns 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.
Sum
I $ 85.00 ~
3 $ 15.ooL.6
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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 ~r 1000
Branch Circuits
t
40
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each .installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Cir-cuit
Each Additional
Circuit or with Service
OJ:' Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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