HomeMy WebLinkAboutPermit Electrical 1994-08-15225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST:. 726
0FFICE: 726-3759
LEGAL DESCRIPTIONZL
JOB DESCRIPTION
E
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of it.u"nce or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
SPRINGFIELD
usa
ELECTRICAL PERHIT APPLICATION
City Job Number
SCMDULE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Ineluded:Items Cost
1-000 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
Services or Feeders
Installation, Alterations
or Relocation:
Authorlzed
A
Sum
Elec t ri
Address
Ci ty
Supervi
Expirat
Cons t r
Expi ra t
cal-on t rac
Phone
sor cense Number
ion Date
200 amps or less L/'-
201 amps to 400 amps
-
401 amps to 600 amPS
-
601 amps to 1000 amPs-
Over l-000 amPs/voJ-ts
-
Reconnect 0n1Y
SUBTOTAL OF ABOVE
52 State Surcharge
32 Adrninistrative Fee
TOTAL
Temporary Services or Feeders
Installation, Alteration or Relocation
nc\
B
C
D
50.00
60.00
100.00
$
s
s
$
$
s
-130.00
300.00
40.00
Contr. Number
ion Date
Signa ture of Supe rv
Ovners Name
Address
Ci tv Phone
200 amps or less $
ior "rp" to 400 amPs
-
t
Over 401- to 600 amPs $
Over 600 amps or 1O0OloTts se
40
55
BO
e
00
00
trician
.<b)
.00ngrr uffi[-
35.00
2.00 !
I
not included)
40.00
40.00
20. oo
&
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
f or sale , l-ease or ren t '
Ovners Signature:
Branch Circuits
Nev, Alteration or Extension Per Pane1
One Circuit $
Each Additional
Circuit or vith Service
or Feeder Permit
-
$
Miscellaneous ( Service/ feeder
-Each installation
Pump or irrigation $
iieizoutrine Lighti.,g- tLimited EnergY/Res $
E
5
DATB:n
RECETVED
-7
1. LOCATT.ON 0F TNSTALLATToN3240 ,Q Zrcte
I