HomeMy WebLinkAboutPermit Electrical 1997-01-22(
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Nev Residential-Single or
Multi-FamilY Per dvelling unit
Service Included:
I tems
225 FIFTE STREET
SPRINGFIELD, OREGON 9-747
INSPECTION REQUEST: 726
OFFICE: 726-3759 '
, -tA04 EI^ECTRICAL PERHIT APPLICATION
**&,r+nl.M citY
-LL+ s-
Job Nunbe. '/' - I 0l
3. COHPLETE FEE SCBEDI'LE BELOS
1 LOCATI ON OF INSTALI,ATION'rl 5rh,Ji.
DESCRIPTION oI
Permits are non-transferable and pire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTA.LI.ATION ONLY
Electrical Contractor
A
1000 sq.ft. or }ess
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less I
201 amps to 400 amPs _401 amps to 600 amps _601 amps to 1"000 amps_
Over l-000 amps/volts
C
Cos t
s 85.00
s 1s.00
Sum
Add
Cit
ress s
s
s
. $ 40.00
50.
60.
L00.
s130
s300
s40
$ 40.
$ ss.
$ 80.
see rl
00
00
00
00
50. oo
00
00
00
B" a6ve-
00
00
00
00
00
00
Phone tl4l -Ak?L
Supe rvi sor cense Number lLg LS
Expiration Date to-l-q8
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 40L to 600 amps
Over 600 amps or 1000-tofTs
D. Branch Circuitso
0vners Name
Address
Ci Phonel
OVNER ALIJ,TION
The installation is being made on
property f ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE: I
Nev, Al-teration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscel-laneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utline Lightirg-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
o
s40
$40
$20
s36
RECEIVED B
5
oo
I oo
t
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