HomeMy WebLinkAboutPermit Electrical 1996-10-30.. . ,'l:,:.;:r'..1 not r6quire
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SPRTNGFIELE,
PERHIT APPLICATION
Job Nunber q bt t-.1 -7q
.,,tk)3":1.*
225 FITTE STREET
SPRINGFIELD' OREG0N 97!+7"7
INSPECIIION REQUESTt 726-
OFFICE: 726-3759
Pr*
1. LOCATI ON OF INSTALLATION
3. COUPLETE FEE SCffiDtILE BELOV
A. Nev Residential-Single or
Multi-FamilY Per dvelling unit'
3769 Ci ty
Service Included:
LEGALa oZ
DESCRIPTIONa2- /s /a fo I tems Cos t
$ Bs.oo
$ 1s.oo
$ 40.00
Sumo
Permits are non-transferab
if vork is not started vit
of issuance or if vork is
JOB DESCRIPTION
and expire
1-80 days
pended for
L80 days.
2. CONTRACTOR INSTALI,ATION ONLY
Electrical Contractor
Address a -)
Ci ty prrone 3t{3 I 671
Supervis License Numb er t39 AS
Expiration Date Q-t
constr contr. Number =b4a c-,
Expiration Date
Si ture of SuPervising Electrician
L Ll
Ovners
Address
FLcfteW Alteration or Extension Per Panel
One Circuit $ 35'00
Each Additional
Circuit or vith Service
or Feeder P"r*i',"="-/- $ 2'oo d:
MiscelLaneous (Service/feeder not included)
1.000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less I
20J. amps to 400 amPs
-
40L amPs to 600 amPS
-
601. amPs to 1000 amps--
Over 1000 amPs/volts
-
Reconnect 0n1Y
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
Temoorary Services or Feeders
iirl.fi"ii"t, Alteration or Relocation
200 amps''or less E 19'99;oi ;;; io aoo amPs
-
i ::'990;;'-461 io 600 a*fs --. $ eo:99
Over 600 amps or fbOO-voTts see I'B'r above
-Each installation
Pump or irrigation
-
Sign/Outline Lighting-
Limi ted EnergY/Res
-
Limited EnergY/Comm
hin
sus
E
B
C
D
{^ao*-$ s0.00
s 60.00
$100. 00
$130.00
s300.00
$ 40.00
u it *l
cirvMhone hffi -s'ba
ovNER rNsrALLATrcn 1iloul ^)o? q,vr - rri,.
The installation is being made o
piop"ttv I ovn vhich is not intended
for-sale, lease or rent'
Orners Signature:
$ 40.00
$ 40.00
$ 20.00
$ 36. O0
DATE:o - 3o- 4Q
RECEIVED A(Dc)
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