HomeMy WebLinkAboutPermit Electrical 1997-01-28CITY OF SPR"VGFIELD,ONEGOfU
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225 FITTfl STREET
SPRTNGFTELD, OREGoN 97 477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
APPLICATION
Ci ty Job Number
3. COHPLETE FEE SCffiDTII,E BELOV
A Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
s s0.00
s 60.00
s100. 00
s130.00
$300.00
C
LOCATION,/zs-a OF INSTAIJATION,"')))%)*7
TEGAL DESCRTPTION/72<?t a7 /D2N
JOB DESCRTPTION *!_1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home- or
Modular Dvelling
Sertice or Feeder
s 8s.00
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/voIts
Reconnect 0n1y $ 40.oo #o_r
Temporary Services or Feeders
Installation, Alteration or Relocation
Sum
- -z ,/-
Permits are non-transferabLe and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTATLATION ONLY
Electrical Contractor
Address { 7r,
B
Yhone lf ?{533 /
rvisor License Number ]-S'/e I
Expiration Date
Constr Contr. Number c21)
Expiration Date
ure of Su pervis
200 amps"or less $ 40.
201 amps to 400 amps
-
$ 55.
over 401 to 600 amps
-
$ 80.
Over 600 amps or 1000-volTs see "
Ci ty
Supe
Address
,"q trician
Eove
00
00
00
Bft a'
Ci ty
OVNER TNSTAILATION
The installation is being made on
property f ovn vhich is not intended
for sa1e, lease or rent.
Osners Signature:
DATE:
D. Branch Circuits
New, Alteration or Extension Per Panel
one Circuit S 35.00
Each Additional
Circuit or vith Serviceor Feeder Permit S 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
Sign/0ut1ine Lighting- S
Limited Energy/Res $Limited Energy/Comm $
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
o-a
rs Name *t
Phone //9{'-k'2 4
I
40.00
40. 00
20.00
36.00
RECETVED
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