HomeMy WebLinkAboutPermit Electrical 1995-11-17225 FTFTB STREET
1 LOCAT OF ALIATTON
TEGAL DESCRIPTT
JOB DESCPJPTION
o
Permiif vo
of is
180 days.
2. COMRACTOR INSTAILATTON O}II,Y
SPC'INGF'ELO
roquire epecilic land use
PER.I{IT APPLTCATION
City Job Number
3. COHPI,ETE FEE SCffiDtIIJ BELOV
i '..:,'r-
.' lL-(3-:15
S?-RINGFfELD, OREGON 97417 r.r. i: a. .r.i:.r,, i.:INSPECTI0N REQITEST: 126_3769OFPTCE: 726-3759
A Nev Resj.dential-Single orMulti-Family per dvelling unit.Service fncluded:
Electrical Contractor
Address
Ci Phone 'l4l -aaqL
Supervisor Li iense Num ber lbgb $
Expiration oate i0- i -9 6
Constr Contr. Number o3S4 q
Expiration Date -q
Signa_of Supervising Electrician
0vners Name
Address
Ci tY one'
OVNER
I tems
1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Hanuf'd Home or
-
Hodular Dvelling
Service or Feeder
Services or Feedersfnstallation, Alterations
or Relocation:
200 amps or less I
201 amps to 400 amps
-
401 amps to 6OO amps
-
60L amps to 1000 amps-
0ver 1000 amps/voIts
-
(econnect Only
Cf,S$ont'rro.,grnn,
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent'
Ovners Signature:
Cos t
$ 8s.00
s 1s.00
$ 40.00
s s0.00
s 60.00
s1oo.00
s130.00
s300.00s 40.00
Sum
ts are non-transferable and expirerk is not started vithin 180 days
suance or if vork is suspended ior
B
C
ELSO
200 amps''or less $ 40.00
over 401 to 600 amps
-
S 80.00
0ver 600 amps or 1000-volTs see "B" above
Temporary Services or !'eeders -
Installa.tion, Alteration or Relocadion
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
t D. Branch Circuits
Nev, Alteration or Extension Per Panel .
One Circuit $ 35'00
Each Additional
Circuit or vith Service i
or Feeder Permit I S 2'00 g-q-q
E- Miscellaneous (Service/feeder not' included.)
-Each installation
Pump or irrigation
-
Sign/Outline Lighti.g-
Limited EnergY/Res
-
Limited EnergY/Comm
$ 40.0q
s 40.00
s 2o.oo
s 36.00
5
DATE:
T'DAETITPN R
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