HomeMy WebLinkAboutPermit Electrical 2001-08-20225 FIT-TB STREET
SPRINGFIELD, OREGON
INSPECTION REQTIEST:
OFFTCE: 726-3759
1 OF
approval.
Zoning
Date
TTON
The lollowing project as submitted has the lollowing
zoning. and does not require specific land use
5 rxqFlELO
ELECTRICAT PBRIIT APPLICATION
City Job Nrrnber O/ - o o ?o f ^o/
JOB DESCRIPTION
Electrical Contractor
Add ress
Ci ty Phone codi
Supervisor License Number JoZZ t
Expiration Date
Constr Contr. Number ./o o(
Expiration Date
Signature of Supervising Electrician
Owners i'iame
Address */2 f tL
Ci ty 5 (t^Phone
Permits are non-transferable and expireif vork is not started r,ri thin-igO daysof-issuance or if vori i;';;;p;"ded for180 days.
2. CONTRACTOR TNSTAII.ATTON OIIY
COHPLETE FEE SCBEDUIJ BELOT'
Nev Residential-Single orHulti-Family per dwetling unit.Service fncluded:
I tems Cos t
1000 sq.ft. or lessEach addi tional 500sq. ft or portion
thereof
Each Manufrd Home. or --
Modular Dwelling
Service or Feeder
9?77
3
A
LEGAL| "7 r>)
PTTONl O Tfoo
Sum
OITNER TNSTALLATTON
The installation, is. being made onproperty I ovn vhich is iot intendedtor saIe, lease or rent.
0mers Signature:
Services or Feedersfnstallation, Alterationsor Relocation:
200 amps or 1ess \201 arnps ro 4OO amps +
401 amps ro G00 il;; =-
I01 "Tp:_ to 1000 "f,p"-Over 1000 amps/volr'--Keconnect Only
Hiscellaneous (Service./fee
-Eaeh installaiion
rump or irrigation
; i fl i {3H,*i::,,'if,ht i ns-
Ltmi ted Energy/Comm
Tempo_rary Services or Feedersrns tallation, arteraiion-=JI'i"toca tion
319 :lr' 'or ]9es $ 4o.oo1ul amps to 400over abi i; ;fi ::t:
-
$ ss'oo
o;;; 600 jir3"l,'lfiio ,.n" j"lo;Sg "#Branch Circui ts
Nev, dfteration or Extension per panel
One Circui tEach Addi tionalCircuit or vith Serviceor Feeder permi t
B
00
der not included)
$ 40,00
s 8s.00
$ 15.00
$ 40.00
S ->o.oo$'6o.oo
$100.00
$130.00
s300.00s 40.00
s 35.00
$z$s
Od
6s L3&
_-
c
D
s 2
E
)0
DATE;5
IU
ff ++{:l
{s
-x(:}l-r
a ,OPEGOA'
RECEIVED
Zoo t -SUBTOTAL OF ABOVE
6'_;i;t;, :i;:f i;5",."
TOTAL
)
,lO -
L