HomeMy WebLinkAboutPermit Electrical 1996-04-23a
I -
225 FIFTE Sf,BEEf,
SPRINGEIELD OREGON 97 477
IIISPE(IION REQIIEST z 726-3769
OFFICE: 726-3759
Authorized Sign rituris 3.
1 I,OCATION OF INSTALI,ATION.44s*a.t )nPr# tDV
IJGAL DESCPJPTION/2o E,/AE
JOB DESCRIPTION
AI,ARM SYSTEM
Permits are non-transferable and expireif vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CO}IItsACTOR INSTALI,A:TTON ONLT
Electrica] Contractor4pl SECURITy
Address 1501 pearl Stre el - Srri tp R
ci Eusene, 97402 Phone (sOl):+Z-t:t:
Supe rvisor License Number R-l777.rr.8
Expi ration Date l0-l-95
Constr Contr. Number 59944
Exp iration Date 4t29
31 aGFlEl.D
BIJECTIJ,CAL PERI{M APPITCATION
-a-3 City Job Nunber s/7
FEE SCEBDIIIT BEI.OV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or --Hodular Dvelling
Service or Feeder
$ 8s.00
s 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps
201 amps
401 amps
601 amps
Over 1000
Reconnect
or lessto 400 ampsto 600 ampsto 1000 amps
amps/vo1ts
OnIy
Sum
a56ve
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
s 40.00
200 amps or less $ 40.00
201 amps to 400 anps I $ 55.00
over 401 to 600 amps
-
S 80.00
Over 600 amps or lOOOEfts see rBn
.1[ ,op
$ 40.00
$ 40.00
$ 20.00
$ 36.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signature ot. S;Veyising _Electrician
(/ -,4.-4//
0sners Nan
Addre tl-
cit@Phone'siil, 47 4. drol
OVNER INSTALI.ETION
The installation ls being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ouners Signature:
DATB:
New, Alteration or Bxtension Per Pane1
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Hiscettaneous (Service/feeder not included)
D. Branch Circuits
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
-Each installation
Pump or irrigation
sign/outline Lightins-
Limited Energy/Res
-Limited Energy/Comm
5 ,2>b, r>o
t,8c
- TW-
4K,RT,RECETVED
aq submrttod has t'he {l