HomeMy WebLinkAboutPermit Electrical 2000-3-13
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Zonl~-.:. ('" - (TV -~W:.L.UaCAL PERMIT APPLICATION,
97477 Date - - ~ - ('J q 0 '5 0 I
726-3769 . ed Si9nalUl. City Job Number ~l - \ ~~-
AuthOnt
225 FIFTH STREET
SPRINGFIELD I OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1.
3, COMPLETE FEE SCHEDULE BELOY
LOC~J.O~,OF INSTALLATION
~'~ () Leo+- G.
. LEGAL lll>SCRIPTION ""0
\ 70~ ,:Y:, ( n '5 L.(r:v
JOB DESCRIPTION
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Permits are non-transferable and expire
if vork is not started vithin 180 days'
of issuance or if vork is suspended for
180 days,
.'
2. CONTRACTOR INSTALLATION ONLY
B. Services or Feeders
Installation, Alterations
or Relocation:
Electrical Contractor ARC ELECTRIC INC:
Address Rt:;7R~ HWY QQ c::nTT'T'U
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
Ci tY.1',II(;1'.1\I1':
Phone 741-0494
Supervisor License Number 40795
Expiration Date 10/1/01
$ 50,00
$ 60.00
$100,00
$130,00
$300.00
$ 40.00
Constr Contr. Number 20-403C
C, Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date ln/m In(1
Si~gnt V~ctrician
-' ~
Own s Name /(1\ {:;"I'\:501-,,"
200 amps' 'OT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump oi irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
'1 C-!.;).4
{!: ((), v\, /J.
I
One \Ci rcui t
Each Additional
Circuit or with Service
or Feeder Permit
Address
Ci ty LJ f r I '1 pelJ Phone
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or ren t :
E.
Ovners Signature:
---------------------------------------"
5.
SUBTOTAL OF ABOVE
51 State Surcharge
31 Administrative Fee
TOTAL
DATE:
RECEIPT It:
RECEIVED BY:
'$ .40.00
$ 55.00
$ 80.00
volts see "B" above
$ 35.00
$ 2,00
no t included)
$ 40.00
$ 40,00
$ 20,00
$ 36,00
2&
S6U
.2.40
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