HomeMy WebLinkAboutPermit Electrical 1998-01-21SPr-.IGF|ELO
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Date
ZZ5 FfFTE SIREET Authortsod
SPRTNGFIEI.D, OREGON 97477
6luoINSPECTION REQI EST 2 726-37
OFEICE: 726-3759
1 OF INSTALI.ATION
I,EGAL DESCRTPTION
JOB DESCRIPTION
Tryzrt'ftazdar W
Permits are non-transferable and expire
lf vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COIITRACf,OR INSTALI,ATION ONLY
PERI{IT APPLICATION
City Job Nurnber
3. COHPT,ETE FBE SCEEDT'I^E BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
$ 8s.00
$ 1s.00
$ 40.00
.8. Services or Feeders
Installation, Alterations
or Relocation:
SHI
A.
Electrical Contractor f /rI,
Addres w elL.4-
City Phone
Supervisor License Number ?tro s
ExP iration Date
Constr Contr. Number
ExP iration Date t/- e t '??
tur? o Superv
200 amps or less
201 amps to 400 amps
-401 amps to.600 amps
-601 amfs to 1000 amps-
0ver 1000 amps/voIts
Reconnect Only
s s0.
$ 60.
$100.
$130.
200 amps"or less $ 40
201 amps to 40'0, amps
-
$ 55
over 401 to 60Qlamps
-
$ eO
Over 600 amps.'6r 1000 vorfs see
s300
Sum
nBu aEili,il
00
00
00
00
00
00
00
00
00
S 40.
alssl Temporar;Sservices or Feeders
Installdgi$r, Alteration or Relocation
I
c
(
Owners Name
Address /4 /? %e ,)Dt
D; Branch Circuits
One Circuit t-'
Each AdditionalCircuit or vith Serviceor Feeder Permit
E Hiscellaneous ( Service/feeder
-Each installation
Pump or irrigation $Sign/outline Lighting- S
Limited Energy/Res
-
$Limited Energy/Comm S
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
Nev, Alteration or Extension Per Pane1
.(.)
i
cttv frqft . enone tf7-7d(,7
OTTNER INSTALII\TION
The installation is being made onproperty I ovn vhich is not intendedfor sale, Iease or rent.
Ovnersi}$ignature:
DATE:
$ 3s.00
s 2.00
3g
not included)
40.00
40.00
20.00
5
RECEIVED
oO
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
-Hodu1ar.'Dvelling'
Sertice or Feeder
s\ Bo
uSoNn SIHT
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'7O\ sce Lz O/rcf .
Electrician