HomeMy WebLinkAboutPermit Electrical 2008-3-11
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225 FIFTII STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number '. Co t4/\ ZL>~ g- - 00 r g Z
1.
LEGAL DESCRIPTION:
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JOB DESCRIPTION:
/-10 lASe W I (L~
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
------ -- -Suspended,Jm:-180-da.)'s_-_____~'__
2.
Electrical Contractor ~q;J)J1J1cJ., r-Iec
I
Address
;;Lo879
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CIty
l'DOne 50// >l7777o
Supervisor License Number 1..f 0:5'" 75
Expiratio? Date' an '7
Constr. Contr. Number /7;2 '"?;>~ ~
Expiration Date ~ 9'
Owners Signature:
Inspection Request: 726-3769
Date
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
--Eee_der
(
'2
$117.00
$ 21.00
$55.00
B.
200 Amps orless
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over lUOo-AIUpslVo]ts
Reconnect Only
$ 70.00
$ 83.00
$138.00
$180.00
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$ -55.00
c.
'~':'"
'.;ii,.~
$ 55.00
$ 55.00
.'$~8:00--
:& 50.00
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- 12% 8ta ;charge
]0% Anmini.strative Fee
5%'Techno]ogy Fee
'2 I (/
z.~6B
Z-!f./v
1070
/ 79
7--7 -'
TOTAL
Shared Drive(T:)/BuiJding FormslElectrical Permit Application I-08.doc