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HomeMy WebLinkAboutPermit Electrical 1997-01-22( :iPtslIN(iFITL() 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 -q4