HomeMy WebLinkAboutPermit Electrical 1995-01-20SPF. ,FIELD
OREGONCITY OF
following projecl as submitted has tha
IOni ng, and doe$nol require spectfic land use
approval.
225 FTTTE SIREBT
SPRINGFIELD OREGON 974 77 Zonins . Cg
INSPECIION REQIBST. 72 o-ak62J:u:qI
OFFICE: 726-3759
Authorizeci
BI,ESTT,ICAL PERI{TT APPLICATION
City Job Number
COT{PLBTB FEE SCEEDT'LE BELOII
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost
$ 8s.00
Sum
1
JOB DESCtsIPTION
Re^o^s- "*rrt;,-t 5r /tt ct1.{ 2lA' tbc)
i*-s:y} i^ : si PH^-*'nt d7a;^'7
PE-rmiis" ire non-transferable and expfre
if vork is not started vithin L80 days
of issuance or if vork is suspended for
180 days.
2. COI{TRACTOR INSTALLATION ONLY
A
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf 'd Ilome or
Modular Dvelling
Service or Feeder
B. Services or Feeders
InstaIIation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-40L amps to 600 amPS
-
601- amps to 1000 amPs-
0ver 1000 amps/volts
-
Reconnect 0n1y
C
E
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
$ 1s.00
$ 40.00
Electricaf Contractor E'
Address / Z /C Y ,\ ftaa
Ci ty Phone bx?-t-'>tl J
Supervisor License Number > >-!
Expiration Date
Constr Contr. Number
Expiration Date 2 * t-',is
Signa ture of Supervising Electrician
Temporary Services or Feeders
Insiallation, Alteration or Refocation
200 amps or less
201 amps to 400 amPs
--0ver 401 to 600 amPs
Over 600 amps or 1000 voTt
-Each installation
Pump or irrigation
Sign/OutIine Ligh t ing--l-
Limited EnergY/Res
Limited EnergY/Comm
$ s0.00
s 60.00
$100. 0o
$130. 00
$300.00
$ 40.00
$ 40.00
$ ss.00
$ 80.00
s see rrBtr a 6ove
I
Ovners Name
Address
2.,bY *c'l le^, ,1,
D Branch Cireuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35'00
f""f, naaltional
Circuit or vith Service
or feeae. Permit
-
$ 2'00
Miscellaneous (Service/feeder not included)
l,-
Ci ty vhone 6f,'(- qc/ <3
OVNER INSTALLATION
The instal-l-ation is being made on
piop"tty I ovn vhich is not intended
for safe, lease or rent'
Ovners Signature:
s 40.00
$ 40.00
$ 20.00
s 36.00 .
DATE:
RECEIVED B
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