HomeMy WebLinkAboutPermit Electrical 1998-06-23CITY OF SPR OREGOA'
SP}\ .iFIELO
DEVELOPMENT SERVICES
225 FITru SIREET
SPRINGFTELD, OREGON 974
fNSPECTfON REQUBST: 72
OFPICE: 726-3759
1
approval.
requlne specilc lend
TL
EI,ECTRTCAL PERHIT APPLICATION
THE WOHK
,b Number aToZU
COMMENCED OR IS ABS.IDOUEEdi(ET EEE SCffiDIILE BELOII
ae erbmltted has tho
A
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-37s3
FAX (541) 726-368e
Sum
$ s0.00
$ 60.00
$100. 00
$130. 00
s300.00
$ 40.00
Permits are non-transferable and expireif vork is not started vithin 180 days
of issuance or if work is suspended for
L80 days.
2. COI{TRACTOR INSTALI..ATION ONLY
Electrical Contrac tor E 5 ilt-de,cfro Ca*s-
Address Q.oGor )ve'3\
LocATIoN oF INSTALLAIEVI.\I8O DAY PERIODI Bo a^-.\t qr
LEGAL Lb 5a r.r
JOB DESCRIFTION
Ur"+
Phone (o?(o ^bi} 3 \
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:ftems Cost
1-000 sq. f t. or Iess
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
-Modular Dvelling
Ser,yice or Feeder
$ 8s.00
s 1s.00
$ 40.00
Ci ty
Supe
B. Services or Feeders
InstaLlation, Alterations(+*E or Relocation:
lryC-
200 amps or less
201- amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/voIts
-Reconnect 0n1y
200 amps or less $
201 amps to 400 amps
-
$
Over 401" to 600 amps
-
$
0ver 600 amps or 1000loEs s
-Each installation
Pump or irrigation S
Sign/Out1ine Lighting- $Linited Energy/Res
-
$Limited Energy/Comm $
rvisor License Number 3*rtl S
Exp iration Date /a-( - 1 {>
Constr Contr. Number /d t;f
Expiration Date v
Signature of Supervising Electrician
Address t 3O f,/.,'.
Ci S1-rr Phone -?)(r- b? 13
U
OI'NER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
C. Temporary Services or Feeders
fnstallation, Alteration or Rel-oeation
40.00
55.00
80.00
ee rrBrr a6ove
D. Branch Circuits
Nev, Alteration or Extension Per Panel
> I^,0ooneCircuit I $35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miseel-Laneous ( Service/f eeder not incl-uded)
40.00
40.00
20.00
36.00
39.OASUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTALRECEIVED
5
l,7T
Owners Name Q,Pt st # 0 x t-at*