HomeMy WebLinkAboutPermit Electrical 1995-03-20CITY OF OFEGO'U
zoning, and
approval.
225 FIFTH STREET
SPRTNGFIELD, OREGON 97477
TNSPECTION REQUESTz 726-37
: f. LOCATION OF TNSTALLATION
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JOB DESCRIPTTON +
Permi ts are non-trans ferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTAII.ATTON ONLY
ElectricaL Contractoqi[S0]l ltE[ii:![ SlIYitE
Address P,- 15.,t _a-)
SPRINGFIELD
ELESTRICAL PERXIT APPLICATION
City Job Number
dceanot require specific land
A Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf '<i Home or
-Modular Dvelling
Service or Feeder
$ 8s.00
s 15.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
Sum
pi,oneAt-{S- lc,tl
200 amps or less I
201 amps to 400 amps
40L amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/volts
-Reconnect 0n1y
200 amps or less
20L amps to 400 amps
-Over 401 to 600 amps
-Over 600 amps or 1000-voI-ts
-Each installation
Pump or irrigation $
Sign/Out1ine Lighting- S
Limi ted Energy/Res
-
$
Limited Energy/Comm S
s 50.00
s 60.00
s 100. 00
s130.00
s300.00
s 40.00
$ 40.00
$ ss.00
$ 80.00
See rtBt' aE'OE
5.]"-.t,
B
c
g
Ci ty
Su'!ertis License Number /3q& 5
Expiration Date
Constr Contr. Number , l;c-r4 L, C-
Exp iration Date /U - qS
ture of Supervising Electrician
Temporary Services or Feeders
Installation, Alteration or Relocation
0vners Name
Address s.5cl-*-r-
C'i tv Phoneu. , t _
Osners Signature:
oIJNER TNSTAILATIoN b|D *,4_
The installation is being madU'Bn
property f ovn vhich is iot lnttfiaed^
f or saIe. lease or ren t . '''
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit I S 2.00 .}(rc
E. Miscellaneous (Service/feeder not included)
40. 00
40.00
20. 00
36.00
SUBTOTAL OF ABOVE
52 State Surcharge
32 Adninistrative Fee
TOTAL
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DATE:
RXCEIVED
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OFFTCE: 726-3759
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