HomeMy WebLinkAboutPermit Electrical 1992-4-8
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225 FIITH STREET ~PPtoe~i"J:J c/o,,"~~. (,(JbrnHi~d hELECTRICAL PERMIT APPLICCBl-ATION )(
SPRINGFIELD, OREGON 97477 ' ,equlr~ .P"cjflo~~:I:lollelVlnd ' /7'-;
INSPECTION REQUEST: 726-3769. Zcni'1g Ci hlJ:Job Number '-1 ( ....
OFFICE: 726-3759 ~to.
Al/l,~
L LOCATION.f)OF INSTALLATION ~Si!Jna1ure
P--n. ,<-AI N~O"'" "'Dl\. .'bff D
LEGAL DESCRIPTION \103 'd '"' 2ft -""'~
'\)P\(\.\ - Mt'I-(\.7 -=# /t, jJ~
SI.IIINc.;t:I~LU
P TE FEE SCHEDULE BELOV
Residential-Single or
Multi- er dwelling
Service Included:
Items
unit .
Cost
Sum
JOB DESCRIPTION tek:\oo~- '-'I~' 1000 sq.ft. or less $ 85.00
~~UI~ Each additional 500
sq. ft or portion
Permits are non-transferable and expire thereof $ 15.00
if work is not started within 180 days Each Manuftd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder $ 40.00
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~,P\l/.{)
EcG-c.
Address,Q703 \)all,l\-7 VAL'-C,/ ~C~~,
Ci ty f!.c;;T7i'1..F GIlo J~ Phone 9<11.. - J (,? ~
Supervisor License Number
.7~ 7 0 8' S.
Expiration Date
'3 Jq 3
t
Constr Contr. Number ~8'!;!,'3 (.,
Expiration Date ?/9"'='.
. SiD;~~f
Owners 'Name
Supervising Electrician
f4,~,
-uAl\.\ - ""l'<(\.."7
D.
"7" Oi\.t<' ,
Address IA(.,X' C:;r'L~ l..0oo0 57
City ',C,7 CIT'-{
Phone
99 ,? - "Z- '3 8'd'
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~:-:~4~~-??-4;;=:S--
RECEIVED BY: ("'/'it j /11 , -
-. -----
B.
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00 ~
Reconnect Only \ $ 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
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B" above
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$
$
S
S
4{')CO
:L: u c)
~.bJ
40.00
40.00
20.00
36.00