HomeMy WebLinkAboutPermit Electrical 1998-3-13
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.uthorized Signature. ~ '" iJ::- l' 8 6 0 ? B \~~ ~o~'(... -
225 FIFTH STREET ~ ~~CAW \~~i~T APPLICATION
SPRINGFIELD, OREGON 974 77 ~O~\C. S~~\..\.. S ~~~\ol\\ \ ~ q (t. D 7 (' /
INSPECTION REQUEST: 726-3769 CO?~~~\\ \\~O~W1~ .J~~D~er X 0 0
OFFICE: 726-3759 \~~ nP.\t~O~'-n~~~~~U' '
~\J\~~: €e~l'1:1:E FEE SCHEDULE BELOV
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A6t.&~ A~~~~l\eSidential-Single or
~'( '\ Mul t i-Family per diirelling uni t.
Service Included:
LOCATION OF INSTALLATION
It 1... 9) j;-~ 2 9..3
1.
/7o:13S[f)BjO!:o't
Items
Cost Sum
$ 85.00 rS,60
$ 15.00 IJ5 .00
$ 40.00
I
3
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling ,
Service or Feeder
JOB DESCRIPTION
N'~ Iv' ~ /J 1.Jd TJ
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 ONLYB.
Electrical Contractor r ~;,/ f/,.;:/Vl-~0
Services or Feeders
Installation, Alterations
or Relocation:
Address p 1/, g~y. ?~S-
Ci ty -.L..../' ., '5' ~-e-,J Phone 94L- Z
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
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
2 26 8
Supervisor License Number, /8/-<
/d///?/1
- ~c, (;
Constr Contr. Number ;j /7~~1
k/~~/9P
e' I
Expiration Date
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
see "B" above
200 amps':oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Expiration Date
Signature of Supervising Electrician
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/ - .6 . I ~ . A CJc;j/ D.
Owners Name J JL-v- 1 {J ((')1 () (f(j4h
Address 307St;; ~((; (OY~/fLA
Ci ty CDttt1ClP ~ U/tVLPhone!iLL! l--lfSQ\{
OWER I&STALLATION
Branch Circuits
,.
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or' Feeder Permit
$ 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 I ~ OJ oQ
5% State Surcharge (tJ ,~_U '
3% Administrative Fee '/.1 (j
TOTAL / I/O, flo
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~A~~~---~;tj~;t~~~=-~---------------~
RECEIPT #:1' '.. ()el-<-!OK\"
RECEIVED BY: )"'\ ~nl"r .{A~~
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