HomeMy WebLinkAboutPermit Electrical 2000-11-22CITY OF SPR"VGFIELD, OREGO'V
INSPECf,ION REQUESTz 726-3769ttrorrzeo siEnature
OFFICE: 726-3759
SP}..,YGFIELE
'fhe tollowing Proiect as submitted has the foll
aontng and does not require sPecilic land use
LDL
lt t l/.-da PERI{IT APPLICATION
b Nurnber oc - cs l-7 ^C)
3. COHPI,ETE FEE SCffiDTIIJ BELOS
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
approval
Zoning
225 TIPTE STREET
SPRTNGFTELD, OREGON 97477 rate
1. LOCATION OP INSTALLATION
Ot;a\ Af3il0
I,EGAL DESCRTFTIONll o's'zLr3 I zto "-'Sum
JOB DESCRIPTION
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. COMRACTOR INSTALI,ATION ONLY
Electrical Contractor u
Address
Ci ty pnone I glL?ZY
Supervisor License Number
Expiration Date,-a t -01
Expiration Date
ture of sing rI.c1an
rs Name IJ
, t Installation, Alterations
fuhL or Relocation:
l-000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
B. Services or Feeders
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit \
SUBTOTAL OF ABOVE
7% State Surcharge
32 Administrative Fee
TOTAL
$ 8s.00
$ 1s.00
$ 40.00
s s0.00
s 60.00
sloo.0o
s130.00
s300.00s 40.00
_sEto
-
Addre ss 7//o O€tocc
200 amps or less I
201 amps to 400 amPs
-
401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amPs/voIts
-
Reconnect OnIY
Temporary Services or Feeders
Insiallaiion, Alteration or Relocation
200 amps''or less
201 amps to 400 amPs
-
0ver 401 to 600 amPs
Over 600 amPs or 1000
Branch Circuits
rTol[Ts see rrBrr aEoF
Nev, Alteration or Extension Per Pane1
$ 3s.00
oos 2.00 L.
-Each installation
Pump or irrigation
-
Sign/Outline Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
c
D.
$ 40.00
$ ss.00
s 80.00
(r
Phone 726 - 7ol 7Ci ty
OVNER INSTALLATION
The installation is being made on
piop"tty I ovn vhich is not intended
ior sale, Iease or rent'
Ovners Signature:
E Misce]laneous (Service/feeder not included)
$
s
$
s
40.
40.
20.
DATE:l(
RECEIVED B
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