HomeMy WebLinkAboutPermit Electrical 1994-03-03C'TY-OF ,0
225 FIFTE STREEI
SPRINGFIELD, oREGoN 974
INSPECTION REQIIESTz 72
0FEICE: 726-3759 Zonin e
1 LocArroN 0p rNs?Alr.lttrs}I-9lal.ey
LEGAL DESCFJPTION
JOB DESCRIPTTON
irlstu /l Secu n At/
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. CONTRACf,OR INSTALI"ATTON O}TLY
ELECTRICAL PERHIT APPLICATION
t
es submltted has the followirgreguire specilic land
ab
li: l'' l.: ,: ". ?'t?l
6+3?b9 ' 'r 'L!i ir''uttity Job Nunber q t-lo?1
I^STE FEE SCEEDULE BELOV
Nev Residential-Single or
Iy per dvelling unit.
Service fncluded:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Hodular DweIling
Service or Feeder
s 8s.00
s 40.00
Services or Feeders
Installation, Alterations or
Relocation:
Sum
s 1s.00
s 50.00
$ 60.00
$100. 00
s130.00
$300.00
s 40.00
B
Electrical Contractor
Address t A. Ba-x Cl)Og
city Zt-U.nl-+Zr/St l3Phone
,aI(J
Supervisor License Ntimber /7t3 JLE
Expiration Dare /0-f- 7G
Constr Contr. Number b5 /4q
Exp iration Dat-e (. /Jg /q/.
Signatr;te of Supervising Electrician
Ovners Name
Address .5arn<
Phone 74L-.1/lJ
200 amps or less
201. amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/vo1ts
Reconnect Only
*,
C. Temporary Services or Feeders
Insta1lation, Alteration or Relocation
200 amps or less S 40.00
0ver 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see "8" above
Ci ty
OIINER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:3
RECEIPT
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
one Circuit S 35.00
Each Addi t ional
Circuit or vith Service
or Feeder Permi t S 2. 00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
Sign/outline Lighting- $
Limited Energy/Res S
5. SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
00
00
00
00
40
40
20
36 Wz)
RECEIVED BY: flA
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