HomeMy WebLinkAboutPermit Electrical 2002-04-08225 FTFTH STREET
SPzuNGFIELD, OREGON 97477
INSPECTION REQIjES
ELEU T.RICAL PERMIT APPLICATION
-Family per drvelling unit.
Sen'ice Included
Items Cost
LOCATION
"tLl {OF INS
z.>
LEGAL DESC
la0 33
Authorized Signature
ON oataoRIPTI
1., t '/
JOB DESCRIPTION
,iC t+ANb{
Address roe)
'pt',oneSV/,
Contr. Numb er C{8
Adrlress 4Vf
The installation is being made on
properry" I orvn rvhich is not intended
lor sale, lease or rent.
C rror.-
1 1000 so.ft. or less't Each aiditional5oo
sq. ft or portion
Installation, Alterations or
Relocation: :
200 arnps or less
201 amps to 400 amps
.101 amps to 600 amps
601 amps to 10
1000
cmlorar!'
ing the center. (Not 000 volts see
D. Branch Circuits
Nerv Alteration or Extensiou
One Circuit
'- 4-72{Each Additional Circuit or rvith
or Feeder
der not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Linrited Energv/Res
Limited EnergviComm
$ 106.00
$ r 9.00
.00 6)
$ 75.00 _
Sum
Permits are non-transferable attd expire tltereof
if work is not started withil0ffi&ES Each Manufd Home or
of issuance orif work is sqqgQ$ffiltf SHRI-L EXPIRE tM$ffiW0R,Kting
180 davs' ' AUTH0RIZED UNDER THls PERfrfirriSgffiderl:I:::::i-^-;;^ ,; ^n^.n^*En Enp2 coNrRACroR INsrG0lvl{d[NEftOR lS AB$.N9S$IE& F9il"4"^
. :. -- ANY 180 DAY PERIOD.r
Electrical' Contracror ?d q e W ff#ytcr
$ 50.00 _
$50.00
$50.00
$25.00
$-15.00
l\Iinimum Electric Permit lnspection Fee is 545.00 * Surcharges
1. SUBTOTALOTABOVE
7%o State Surchlrge
8%o Administrative Fee
<t
567
6"t g
TOTAL ?3'f
submitted has
specilic
I
Supen'isor
Expiration
Licensc Nrunber lOq2S
Expiration
Signature of Supervising ElectrQ&S9'You maY
numberforthe Oregon
Centeris 1
Orvners
Feeders
Relocation
COMPLETE FEE SCI{EDULE BELOW
or
$50.00
$69.00
--$ I 00.00
p), sf
Orvners Signature:
$43.00