HomeMy WebLinkAboutPermit Electrical 1997-02-25225 FIFTE STREET
S-PIINGFTELD, OREGON 97 477INSPECf,ION REQUEoFPrcE: 726_37s;rz 726-3169
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tiroriied signature l.l IY\-
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EI.^ECTRICAL PERHIT APPLICATION
City Job Number ltoso I
1 roN 0.F TNSTATLA TION
JOB
A
Pe rml ts are non_tr ferable and exifvorkrs not starte d vi thin 180 dof issu ance or if vor k is suspende d180 day s.
2. CONIRACTOR TNSTALI,ATTON ONLY
Elec tri ca1 Con trac tor
Address
Ci ty Phone
Supervisor License Number
Expiration Date
Constr Contr. Number \ro
Expiration Date q
Signatgre of Supe rvising Electrician
.-4
0vners Na (
Address
cit Phone
INSTALLATION
DATE:
3. COHPLETE FEE SCMDULE BELOV
A. I'lev Residential_Single orMulti-Famifv no. .1,,i.,-.r-.. ]lServi.. rn.irjer. dvelling uni t '
f tems
1000 sq.ft. or lessuach additional 500sq. ft or portionthereof
Each Manuf,d Home. or
-
Hodular DvellingSertice or Feeder
\Cos t
s 8s.00
's 15.00
s 40.00
Sum
pi re
ays
for
Services or Feeders
Seel i:";:ii:j I r;
-ai i" i. t i on.
?99 amps or less Izut amps to 400 "rps
+
401 amps ro 600 ;;; --
601 amps to 1000;i"_Over i,000 amps/voIReconnec t O.,iy
s)s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
The instaflation. is being made onproperry r ovn vhich i.;";";;tenaeafor saLe, lease or rent.
Ovners Signature:
- T_"rpolary Services or Feederstns tallation, aI teraiion--Ji.n"rocation
200 amps',or ]ess 6201 amps ;; ;;6'"rps --- 3 13:33over 401 to 600 ;1ry __ i ,0.0,over 600 amps or fbOO-roft" juu ,,8,, a66iE_
Branch Circuits
Nevr Alteration or Extension per panel
One Circui tE""h -;;i;iion"t s 35-oo
Ci rcu i t or vi th Serv i eoor Feeder Permi t -a S 2.00 4_
l;:f i;:::ii,Ii..;"rce/reeder nor included) .
IyT!.:. irrigatii;. s 40.00s rgn,/Ou t I i ne Li r
C
D
E
5
RECEIITED B
S"UBTOTAL OF ABOVEjf :l.te. Surcharge
-_rz"_Aollf nlS tra tive FeeTOTAL.
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