HomeMy WebLinkAboutPermit Electrical 1995-07-05SPRII' 1'IELt)
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ag Subrr;i;r::td hat t!:,1, f,rl]regui;,r )li{).:i;,il rl;iir ilt;LOLZcn3-5225 FIFTH STREET
SPRINGFTELD, oREGON 9
INSPECTION REQTIEST:
oFPICE: 726-3759
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JobNurnbe, qSll/Ci ty
3. COI{PI,ETE PEE SCffiDTILE BELOV
I.EGAL
JOB DESCRTPTION
D lr.q5 ne.;ts are no ble and exp re
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALI,ATION ONLY
Electrical Contractor
Address
Ci ty E1f ".et.O Phone
BI,E TRTCAL PERHIT APPLICATION
New Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
I tems Cos t
$ 8s.001000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
-Modular Dvelling
Sertice or Feeder
s 1s.00
s 40.00
7N7.,,.,:,:,t
726-3769
1 LOCATION OF;35 Sc,-
INSTALI,ATIONBE ,rK ru A.
llorr:n Dci rl.Nz
z36t)Sum
.I-\\s
P
_,
Supervisor License Number
B. Services or FeedersInstallation, Alterations
or Relocation:
C
200 amps or less
201 amps to 400 amps
-40L amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/vo1ts
Reconnect Only -T-
Temporary Services or Feeders
Installation, Alteration or Relocation
C
s s0.00
s 60.00
$100.00
s130.00
s300.00s 40.003q/s W,@
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
0vners Name
OOO:"t"
Ci ty --- Phone
OVNER INSTALLATION
The instaltation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Onners Signature:
DATE:
200 amps"or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 4b1 to 6oo ambs
-
$ Bo.oo
0ver 600 amps or 1b0O voTts see *Bu a66E-
D. Branch Circuits
E
Nev, Alteration or Extension Per Panel
one Circuit $ 35.00
Each Additional
Circuit or vith Service
orFeederPermit lO S 2.00 ZOOC
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/Out1ine Lighting_
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
32 Admini.strative Fee
TOTAL
s
s
$
s
40
40
20
36
.00
.00
.00
.00
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CITY OF OREGON
RBCEIVED B
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