HomeMy WebLinkAboutPermit Electrical 1996-3-6
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SPRINGFIELD
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225 ,u~.t> STREET 3'i')9 ,(\\ \) ~ ELECTRICAL PERKIT APPLICATION
~~:~~:fREg~~~ 9~;~:3~lj._ ~ 12 Ci ty Job Number q S\AA-1
OFFICE: 726-37~ uthorlz 13llll~!!lllUU' ;c-:> ..
. CO f\~ (: \!Lt. /3. OHPLETE I'I\!,; :sCHEDULE BELOV
1. LOCATION 0.. t.;, T ON 7/
C~ ot/~", ",e;".r 0/:> H"t5'$ A. New Residential-Single or
..' ~ ~ Multi-Family per dwelling unit.
\~~ION ()~ ~ Service Included: Items Cost
~B DESCRlPTIOV 1000 sQ.ft. or less
/1';.:' R 5~ C"'t:v /-./.r-..J~' ~ Each addi tiona1 500
sQ. ft or portion
Permits are non-transferable and expire thereof ,
if work is not started within 180 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dwelling
180 days. Service or Feeder
zoning, and does ~ot r;qul;()'~pscifl;lo~d~;
approvaL
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
-::?./ Installation, Alterations
Electrical Contractor ~ ~~/~r~l? or Relocation:
Address /';).. "t) ~ 1....1 5 r 200 amps or less $ 50.00
_ /. ___ .-201 amps to 400 amps $ 60.00
City ~~ e::;rJ~ Phone ;?q q:-5 ~"5 401 amps to 600 amps $100.00
- a ,/ __ 601 amps to 1000 amps $130.00
Supervisor License Number 1 /~'J t-.t:: Over 1000 amps/vol ts $300.00
. j.' AI/''& ~ Reconnect Only $ 40.00
Expiration Date (7, 7 &.
, C. Temporary Services or'Feeders
Constr Contr. Number 9'6.?06 Installation, Alteration or Relocation
ExPir.ation Date ~/1',7 200 amps or less $ 40.00
201 amps to 400 amps $ 55.00
Signature of superv~isin,g Ei~ct ician Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
,/,/-
~ -,
. / I D.' Branch Circui ts
, Owners Name /'7/../C', .-'/<-t );)/?A~
Address \44~6, \ ~ r(t"
City fi 'X:! Qt\OL-Phone 2:5tS"'Rlb(
OVNER I~ALLATION
The installation is beirig made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~;;-:~-~~~~~-----~~~
RECEIVED BY: ~ '. A J'l_ ) "-1"
Sum
$ 85.00
$ 15.00
$ 40.00
New, Alteration or Extension Per Panel
One Circuit
Each Addi tional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
$ 35,00
$
2.00
not included)
$ 40.00
$ 40,00
$ 20,00
$ 36.00
Z6--
5.
SUBTOTAL OF ABOVE
~ State Surcharge
TOTAL
~
~t. -
,?" ~US
~e.B$-
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