HomeMy WebLinkAboutPermit Electrical 1995-09-07CITY OF OREGON
The fotlowing proieclas submitted has the
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225 TIFTE STREET .
SPRTNGFTELD, OREGON 97477
-fr -15
INSPECTION REQUEST :, 726-376A.rhorized
OFFICE: 726-3759'
SPFrI^,GFIELO
ELECTRICAL PERHIT APPLICATION
Number
,COHPIJTE FEE SCMDULE BELOV
A Nev Residential-Single or
Mul-ti-FamilY Per dvelling unit'
Service Included:Items Cost
s 8s.00
1 LOCATION<"t6
OF INSTALT.ATION
,-/. // "''
LEGAL DESCRIPTION
JOB DESCRIPTION
Sum
Electrical Contracto r ./J D Z{ EzF<-
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less J-
201 amps to 400 amps
-
401 amps to 600 amPs
-
601 amps to 1000 amps-
Over 1000 amPs/volts
-
Reconnect OnIY
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
s 1s.00
$00
ee ItBrt aEove
$ 3s.00
$ 2.00
not included)
40.00
40. oo
20.00
f?,o e
;Ls;o
zf aro l,aeF'/otrfZ'
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALLATION ONIY
t
40
Address )-J
Ci ty ff -zza phone ?z ( /zot
Supervisor License Number 3 a 2-3 5
Expiration Dat e q/
Constr Contr. Number 725oc
Expiration Date o Z
Signature of Supervising Electrician
a)-2
0vners Name 7-",v/ ,A/r-/{e
Ci ty Phone F/
Temporary Services or Feeders
Installaiion, Alteration or Relocation\
200 amps''or less
201 amps to 400 amPs
-Over 401 to 600 amPs
Over 600 amps or fOOO voT[s
./,/ /4.e.rlz
B
c
D
E
yus s0.00
s 60.00
s100.00
s130.00
$300.00
s 40.00
40.00
55.00
80.00
$
s
$
s
Branch Circuits
Nev, Alteration or Extension Per Panel
OIJNER INSTALI,ATION
The installation is being made on
property I ovn vhich is not intended
Miscellaneous ( Service/feeder
-Each installation
Pump or irrigation
-
$
SlgnZoutline Lighting- q
Liili ted Energy/Res
-
$
for sa1e, lease or rent.
Orners Signature:
5
DATE:-z
RECEIVED B /.oo
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