HomeMy WebLinkAboutPermit Electrical 1997-2-21
SPRINGF'tELD
~~ /1 a'So) j;&:'i ;J;l/i'k
'ELECTRICAL PERMIT APPLICATION
CI ty Job Number q 7 OJ 7- 7-
A. New Resldentlal-Slngle or
Multl-Famlly per dwelllng Unl t
SerVlce Included
Items Cost
1000 sq ft or less $ 85 00
Each add 1 Donal 500
sq ft or porDon
thereof $ 15 00
Each Manuf'd Home or
Modular DwellIng -
-
Servlce or Feeder. . $ 40 00
LEr~ DE~!;~L/ -{)(bD ( !)
Sum
JOB DESCRlP'(ION n In
_lL"lli\.Q) .illi\..t~MJ UI~
Permlts are non-transferable and explre
If work IS not started w,th,n 180 days
of Issuance Ol If work IS suspended for
180 days
SerVlces or Feeders
Installatlon, Alteratlons
or Re10ca Don
2. CONTRACTOR INSTALLATION ONLY B.
, .
- Electncal ContractorO.d.S ~~
I
Address r.D (()d, lq,2~
. on 1, ~
Clt~(\jr<\C\1nC\\.J.. Phone 1- :1J~1o
Supervlsor Q.~ense Number I b g 10 S
lo-I-Q2
0:\ ~ i{-q
g -I -q'1
$ 50 00 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
Explra non Da te
TemporalY SerVlces or Feeders
,
InstallatIon, Alteratlon or Relocatlon
C.
Numbel
Cons tr Con tl
$ 40 00
$ 55 00
$ 80 00
see "B" above ~
200 amps 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
Explratlon Date
Slgnature of SuperVIsIng ElectrICIan
flAAA'Y&;~
, n~/
Owners Name W\f\rUo r.
Address--1,h 1-:i Cort\-tOfY\J'l\l ll6hxL
Cl ~Y-4(\,; \Y\~~ O~ rt ,_:~~e '14'1-4444-
OVNER I~ALLATION
,
,
Branch Clrcults
D.
New, Alteratlon or ExtenSIon Per Panel
$ 35.00
One C,rcuIt
Each Addltlonal
C,rcuIt or wlth Servlce
or Feeder Permlt
$ 2 00
E. Mlscellaneous (Servlce/feeder not Included)
-Each Installatlop
Pump or IrrIgatlon $ 40 00
Slgn/Outllne Llghtlng $ 40.00
Llmlted Energy/Res $ 20 00
Llmlted Energy/Comm $ 36 00
The Installatlon IS, belng made on
propelty I own WhlCh 1S not Intended
for sale, lease or lent
Ovners SIgnature:
50.00
~ 0 s.t)
to 50
.')4. 00
i~T~~-------~~13Z-r/~~-----------~
RECEIPT 11: Y ').1:'-::( l/J ~ / '
RECEIVED BY: '-t: . i"0 j,<. ^
/ '\.-
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% AdmInlstratlve Fee
TOTAL