HomeMy WebLinkAboutPermit Electrical 1997-07-16225 FIFTH STREET
SPRINGFIELD OREGON 97 477
SPHrr.uFlELt)
Ci ty Job Nunber
(\f.G.. coHpr^gtg oo.E scEEDULE BELoll
Thc lollowing Prolect as
zoning and ooes not re
submir':i l'-e the lollowing
quiiu aPtiri'u !:'rJ Ugo
BLECTRICAL PBRUIT APPLICATION
INSPEC'IION
OFFICE: 7 9
1
REQt'E
26-375
ON OF
ST:
a
ervisor L seN
approval.
726;3,W1kJq
Authorized Signature,
ALLATION
o\c7)oo
A. Nev Residential-Single or
Multi-FamilY Per dvelling unit
Service lncluded:
1
Cos t
$ 8s.00
a le and expire
hin 180 daysit
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Items
L000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home- or
Modular Dvelling
SerVice or Feeder
B. Servi,ces or Feeders
Installation, Alterations
or Relocation:
D
One Circui t
Each Addi tional
Circuit or vith Service
or Feeder Permi t L
Sum
JOB DESCRIPTION
Permits are non-transfer'
if vork is not started v
Electrical Contractor
Add res s
o fS F |,'\iF\ rn,f'\L
Phone'l4l -AaTU
umber I L y6,S
t
cit
suP
Expiration Date io-
Consrr Conrr. Number O.4S4q
Expiration Date q-l--91
S ture of Su pervising Electrician
Ovners Name
Address
amps or less i
amps to 400 amps _
amps to 600 amps _
5o-,-qo
601 amps to 1000 amps_
0ver 1000 amps/vo1ts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 4b1 to 6oo amps
-
$ 80.00
Over 600 amps or 1000 voTts see r?Brr a56G-
Branch Ci rcui ts . ..
Nev, Alteration or Extension Per Panel
$ s0.00
s 60.00
s100. 00
$130. 0o
$300.00s 40.00
200
201
401,
insriutl
dE
dE
$ is.00
$ 40.00
$ 3s.00
s 2.00
I
C
Ci Jflffi'5 JLt^ zz,tq
ON
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
0vners Signature
DATE:
RBCE
E. Miscellaneous (Service/feeder not included)
OVNER 4,e,
-Each
Pump o
Sign/0
Limi te
Limi te
tal-Iation
rrigation
ine Lighting_
nergy/Res
nergy/Comm
$
$
$
$
40.00
40.00
20.00
36.00
5 SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAI,RBCEIVBD B
s4 OC.r
I^EGAL1r: \I I