HomeMy WebLinkAboutPermit Electrical 1995-11-06CITY OF SPR OFEGO'V
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does nol requlro sp€cific hna
fr,(- ELECTRICAL PERHIT APPLICATTON225 TIFTH STREET
SPRTNGFTELD, OREGoN 97477
INSPECTI0N REQIIBSTt 726-376
Ci ty
Supe rvisor License Number lo L 3
iration Date W*1V
zoning, and
approval,
t-
OFFICE: 726-3759 Ar,.thorked ***"-,j
1. LOCATION OF INSTALLATION
Ci ty
SCEEDT'LE BELOV
Nev Residential-Single or
Multi-FamiIy per dvelling unit.
Service Included:Items Cost
1"000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Hatruf 'd Home or
-Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less t
201 amps to 400 amps
-401 amps to 600 amps _
60L amps to 1000 amps_
Over L000 amps/volts
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
4\q) h/"tQ 111
LEGAL DESCRIPTION
L
JOB DESCRIPTION3*as6 Opaz*v
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
1B0 days.
2. COT.ITRACTOR INSTALLATION ONLY
Electrical Con tractor a)bqq6 €LtEffi{,<-
Address tzzr tttl.or,eoq
EulD@.1,6 Phone & 3{+-SsZr1
A.
B
C
Sum
s s0.00
s 60.00
s 100. 00
s130.00
$300.00
$ 40.00
AE
=
a56vil
00
00
00
llrrB
40
55
80
e
Exp
Constr Contr. Number ?o. zze C'
Expiration Date to -1b
Signature of Supe rvlsl Blectrician
0wners Name JL
Address K3O N) \q{A
Ci Phone
OVNER INSTATLATION
The installation ls being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECEI
200 amps or less $
201 amps to 400 amps
-
$
over 401 to 600 amps
-
S
0ver 600 amps or 1000l6ITs se
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Ci rcui t or vi th Service . ,- tnor Feeder Permit 5 S 2.00 L\f." -
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/outline Lighting-
Limited Energy/Res
Limited Energy/Comm
E
5
$ 40.00
$ 40.00
$ 20.00
$ 36.00
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTALRECEIVED
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Job Nunbe.Q 5 t75?