HomeMy WebLinkAboutPermit Electrical 2000-11-08SI GFIELO
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225 FTTtg SlREEf,
SPRINGTIEU), OREGoN 97
INSPECf,ION RE0UEST: 7
oFFICE: 726-3759
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Signature
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BI.ECIRICAL PEBI{IT APPIJCATION
City Job uunuer O c O\Q$ ol
3. COHPI,ETE TBE SCEEDI'IJ BELOS
Sum
1.'q3 OF INSTALI.ATION
JOB
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. COI{TRACTOR TNSTALI,ATTON OT{LY
Electrical Contractor ADT Security
Address 1501 Pearl Sr.
Ci ty Eugene, 0R Phone 541-342-1313
Supervi-sor License Number 8s3JrE
ExP iration Date l0loz
constr contr. Number 262o9cLE
iration Date lo/u/oo
Signa Supervi s Electrician
A. Nev Residential-Sing1e or
Hulti-FamilY Per dvelling unit'
Service fncluded:ftems Cost
1000 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
Instal.lation, 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/volts
Ar)F
I.EGAL DESCRTPTTON
L rq f 3 0 / [,8].)
$ 85.00
$ 15.00
$ 40.00
$
s
s
$
50
60
$300
100
130
$ao
00
00
00
00
00
00
Temporary Services or FeedersInstallation, Alteration or Relocation
Exp
ovners Name Q*tf t n
Address 3).tt f m N{
ci SflP r vr.f't E-t[\Phone
OITNER TNSTALI,ATTON
ee trBil a55iE-
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
One Circuit $ 35.00
Each AdditionalCircuit or vith Serviceor Feeder Permit g 2.00
E. Hiscellaneous (Service/feeder not included)
200 amps"or less
201 amps to 400 amps
-0ver 401 to 600 amps
-Over 600 amps or 1000Ef[s
$
$
s
-Each installation
Pump or irrigation
Sign/0utline Light ing-
Limited Energy/Res 7Limited Energy/Comm
-
40.00
55.00
80.00
$
a-1-
The installation is being made onproperty f ovn vhich is not intendedfor sale, Iease or rent.
0mers Signature:
DATE:
,SuBToTAL 0F ABoVE
@ State Surcharge
32 Administrative Fee
TOTAI,
ry
$ 40.00
s 40.00
$ 20;00
$ 36.00
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CITY OF SPRINGFIELD,OREGON
RBCEIYED
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