HomeMy WebLinkAboutPermit Electrical 2002-03-07225 FIFTTI STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUESTT 726-37 69
OFFICE: 726-3759
Zoning
JOB
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Permits are non-transferable and
if work is not started within 180 days
of issuance or if work is suspcnded for
180 days.
{c lrr,on" 1Ll l-2.2.3f,,
Supervisor License Nurnber llxlS
Expiration Date [0 D I lo3
:1 (/
Constr Contr. Number '' ) 6 ?
ELECTRICAL PERMIT APPLICATION
City Job Nu^W, D Z - OO I 7O 4 l
3. COMPLETE FEE SC}IEDULE BELOW
dwelling unit.
sq. ft or portion
thereof
Each Manufd IIonre or
Modular Dwelling
Service or Feeder
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over I000 anrps/volts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
il#LAfrEr r",,
OR IS
D. Branch
ANY 180DAY
Circuiti PERIOD
Items Cost Sum
$ 106.00
$ 19.00
$ 50.00
$ 63.00
$ 75.00
s125,00
$ 163.00
$375.00
$ 50.00
$50.00
s69.00
$ 100.00
,sNor
S of Supervisin g Electrician
Address
The installation is being made on
property I own which is not intended
for sale, lease or rent.
-oz
"r<;
or less
ional 500
2. CONTRACTOR INSTALLATION ONLY B. Services or Feedersn )C Gl ,rnl^,. ^ --T- Installation,Alterationsor
ErectricalcontractorL.,l ) (.lIL il l(,,J ltL *""#uiton,
AddressP,c- gc,r \Lt8z (3
Expiration Date oilazI
FOH
Name L
,/zo z//L 9
> ( /=\ phone a?/ - 777 Each Addition al Circuit or with Service
OWNER INSTALLATION
New, Alteration or Extension Per Panel
One Circuit $43 00_
$ 3.00
E.
$s0.00
$50.00
$25.00
$45.00
Li
Limited
5. SUBTOTNLOFABOVE
7Yo State Surcharge
8% Administrative Fee
,
Owncrs Signature:
TOTAL --qf
LOCATION OF INSTALLATIONqZA ZlfL_ tt
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DESCRIPTION