HomeMy WebLinkAboutPermit Electrical 1997-01-205.r?!. r.r(;Ft!_aL[)
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Authorizsd225 FTFTE STREET
SPRINGFIELD, OREGON 97 477
INSPECTION REOIEST: 726-3769
OTFICE: 726-3759
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PERI{IT APPLICATION
gOB Humuer t
rEE SCHEDULE BELOIJ
sidential-Singfe or
Multi-Family per dvelI.ing unit.
Service Included:
I tems Cos t
'nnn -^ E.t nr- lacclWVv r{ - I L.
Each add i. t i onal 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
et provi:I.
1 TION OF ALLATION
DESCRIPTION
A
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. CoNTRACToR INSTALI,ATIoN oNL,Y B.
Electrical Contractor otan
Address P 'o Box lobT
SfL Phone @/a"73)5--'
200 amps or l-ess
201 amps to 400 amps
-40i amps to 6O0 amps
60L amps to i.000 amPs-
Over 1000 amps/volts
Reconnect OnlYSupervisor License Number ast-AS-
$ s0.00
s 60.00e1^n nnr/4vV. e!.
s130.00
$300.00
$ 40.00
Ci ty
Expiration Date
Constr Contr. N
Expiration Date 3-ts-78
.J 4'
umber 35U5 I
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
200 amps''or less $
20L amps to 400 arnps
-
$
over 4bL to 600 amp-q
-
$
Over 600 amps or L000loFs se
Ci mr trr re of upe!:v j.s j ng El.ee tr j cj an
Ovners Name
Address l8).5 Vtnttt{
ci ty SPt
-
Phone 14lr'
OVNER INSTALLATION
The insta]lation is being made ort
property I ovn vhich is not intended
for sale, lease or rent.
0wners Signature:
DATE:
RECEI
40. 00
55.00
Eove
80.00
e rtBlr a
D. Branch Circui ts
Nev, Alteration or Extension Per Panef
One Ci rcui t
Eacl'r Addi tional
j
Circui t or vi tl'r Service
or Feeder Permi t 2
E. Miscellaneous (Se::vice/feeder not included)
-Each installation
Pump or irrigation
-
Sign/Outline Lighting_
Limited Energy/Res _Limited Energy/Comm
SUBTOTAL OF ABOVE
57" State Surcharge
3Z Admini.strative Fee
TOTAI
s 3s.oo 35,*
s 2.oo 1*
$40
s40
$20
$so
00
00
00
00
5
RECEIVED B
N
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