HomeMy WebLinkAboutPermit Electrical 1998-11-30CITY OF
225 FIF"IH STREET
SPRINGFTELD, OREGoN 9
INSPECTION REQTJEST:
OFPICE: 726-3759
1. LOCATION OF
2
Notificati
in OAR
477,
1
\ t-s(,-tg
26-
Authorizod
5I'FUAIGFIELO
ELECTRICAL PERHIT APPLICATION
Ci ty Job Nurnbe
SCEEDTILE BELOS
L
i n". ior6vr;*, {oject ae subnl[cd haa t]ro bffcrrltrg,rc; an,J does not requlre epoclllc 6A u;-"-",.)!.il.
'5 A
B
C
D.
Nev Residential-Single or
Multi-FamilY Per dvelling
Service Included:
I tems
Services or Feeders
InstalIation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs
-
40L amps to 600 amps
-
601 amps to 1000 amPs-
Over 1000 amPs/vo1ts
-
Reconnect 0n1Y
Cost Sum
-tt9"
a5ove
$2 00
unit.
qd[nfl fP qe€%JNqedhsf elef$tppeand exp i re
"4,8ffi tw ths qrcsqsMEttu$tojtiffitiantso aays
"i igerUnaie 1o&0Q€3?&LaAis suspended f or
180 days.
2. CONTRACTOR INSTALI..ATION ONLY
[,l0Tl0E:
il:fl.qssFF}8l*4iilry*FRR"!qnrFltuil2FNirt6rn rHIs PEHMIT ls Nor
i fr erge$, r r,,,:; r' i: o R I s Al] /eI$CrNi E t#6f, ' 00
Eacli l'lanuf 'd Horne' or-lrodular Dveltirifi'-''
Service or Feeder $ 40'00
to
les are set forth
h
Electrical Contracto r l.r+, ( 6
Address i) I-9 f)o trl A'(lak
() i 1,,-fIr,$ s0.00
s 60.00
$100.00
$130.00
$300.00
$ 40.00
Ci ty Phone -
Supervi.sor License Number -1d'L ' 1
Exp iration Date /cr,a/TemporarY Services or Feeders
inst"t:.aiion, Alterapion or Relocation/22 4a 7Constr Con tr. Number 6
Expiration Date 't 200 amps"or less f q 19'00ioi "ri" to 400 amps --T- $ :?'oo
over 4b1 to 600 amps - I $ 80'00
Over 600 amps ot- i00O-voTEs see I'8"
Branch Circuits
Signature of Supervising Electrician
u
5G
0vner ame
Addres F.
Ci Phone
OSNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
DATE:
Nev, Alteration or Extension Per Pane1
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 3s.00
E. Misce]laneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/Out1ine Lighting-
Limited Energy/Res
-
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
s 40.00
s 20.00
s 36.00
5
RECEIVED B
0)
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