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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 5 tfr Jla n]2a.2, q?-