HomeMy WebLinkAboutBuilding Electrical 1998-07-10Zoni V
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225 FrFTE STREET
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SPRINGFIELD, OREGON 97 477
INSPECTION REQUEST: 726-3769
OFPICE:' 726-3759
1. LOCATION OF INSTALLATION
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NOTICE:
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SPr ;FIELI)
A
B. Services or Feeders
Installation, Alterations
fu,tor Relocation:
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D.
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAI.
APPLICATION
(o€sl
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
$ 8s.00
s 1s.00
$ 40.00
COMMENCEO OR IS
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I,EGAL
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DESCRTPTION
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JOB DESCRIPTION.4.*<F+drvI\&
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. CONTBACTOR INSTALI..ATTON ONIY
Electrical Contrac tot (5 et tcT Q,Cftro.4qu.l
Address
City t i,-f* *^e--Phone b tA-6>a r^
Supervisor Lic ense Number A-o-)tf<-
Expiration Dare /tt - I -1P
200 amps or less
201 amps to 400 amps _
401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect oniy
Temporary Services or Feeders
Instaltation, Alteration or Relocation
200 amps"or less $ 40.00
over 401 to 6oo amps
-
$ 8o.oo
Over 600 amps or fbOO vofts see rrgtt
"ffile
Branch Circui ts ; .-
Nev, Alteration or Extension Per Panel
-Each installation
Pump or irrigation _ $sign/outline Lighting- S
l,imi ted Energy/Res
-
$
Limited Energy/Comm S
s s0.00
s 50.00
s100.00
s130. 00
$300.00
$ 40.00
Cons tr Contr. Number 2otf"f
Expiration Da te /z -1o*s.l
Signature of Supervising Electrician
Ovners Name 4
Address o
Ci ty
one circuit I $ 35.00 3f '*
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
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OVNER INSTALI,,ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
DATE:
40.00
40.00
20.00
36.00
5
BRECEIVED
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