HomeMy WebLinkAboutPermit Electrical 1993-01-131
225 FIFTH STREET
SPRTNGFIELD, oREGoN 97477
INSPBCTION RBQIIESTT 726-3769
OFFICE: 726-3759 \-
5T'TIINGFTELr)
ELECTRICAL PERilIT APPLICATION
Ci ty Job Number
3. COHPLBTE FBE SCTEDULE BELOV
A New Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ Bs.oo
$ 1s.00
$ 40.00
TOCATION OT,;y8 9.INSTALLATION
= =q {t
Sum
JOB DESCR.IPTION
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Permits are non-transferable and expire
lf vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALI.ATION ONLY
Blectrical Contractor ,ZS
Address J2tZ 1-f-zz ,h-.a-/
Ci ty phone 4r/3--)-€ -
Supervisor License Number 3s2a-5
Expiration Date
Constr Contr. Number
Exp iration Date 2-"Z-
Signa ture of Supervising Blectrician
s Name drfu,(.',
Address 2,
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less --t-201 amps to 400 amps _
401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect Only
200 amps or less
20L amps to 400 amps
-Over 401 to 600 amps _
Over 600 amps or 1000 volt
Temporary Services or Feeders
Installation, Alteration or Relocation
B
5D
00
50.
60.
100.
$
$
$
$
$
$
00
00
130. 00
300.00
40.00
55.00
80. o0
ee rtBtr aE6E
c
40.00$
$
$ss
si jv 2fi,r, 227/,/ Phone
-
OVNER INSTALI,ATION
D Branch Circuits
Nev, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
$ 3s.00
s 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Prrmp or irrigation =..-Sign/0ut1ine Light ing.-
Limited Energy/Res
-
Limited EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent.
Ovners Signature:
DATE:
RECEIPT
$ 40.00
$ 40.00
s 20.00
$ 36.00
5
RECEIVED B
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