HomeMy WebLinkAboutPermit Electrical 1993-10-14C'TY OF OREGO't'
SPR!NGFIELO
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225 TITTE STREET
SPRTNGFTELD, ORBGoN 97477
INSPBCf,ION REQI.IEST:
OFFICE: 726-3759
1.OF INSTALI,ATION
2 ( -zl-
7l$v3769 1c1,-.'-,.-__.--I'_ _l Lqz | 3-Al-U)City Job Nunber
A"lhoiired Si3naturtir 3. COHPLETB PBE SCEEDTILB BELOS
ELECTRICAL PERHIT APPLICATION
Nev Residential-Single or
Multi-FarniIy per dvelling uni t.
Service Included:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
s 8s.00
$ 1s.00
s 40.00
Services or Feeders
InstaIlation, Alterations
or Relocation:
2. COTiITRACTOR INSTALI.ATION ONLY
Electrical Con tractot^fV* t-€z<ftR. ' ,
Address * L I 3 9 ---9a"ulot
Ci ty Phone 7b
Supervisor Licens e Number g/"7-0
Expirat ion oate /0 - f -7,f
Constr Contr. Number ol 9.fo
Expiration Date
Signature of Supervising Electrician
0wners Name
Address
ci ty-Phone
OSNER INSTALI,ATION
The installation is being made on
property I own vhich is not intended
for sa1e, lease or rent.
()cners SigBature:
DATB:
ionirp _
"LEGAL DESCRIPTION
JOB DESCRIPTION
9,.@t
onif
of *Sdhlrc
180 days.
A
B
C
Sum
40.00
55.00
80.00
ee ItBrr aEove
/"a
1B0 days
for
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0nly
200 amps or less
201 amps to 400 amps
-0ver 401 to 600 amps
Over 600 amps or 1000 voTts
Temporary Services or Feeders
InstaIlation, Alteration or Relocation
s s0.00
s 60.00
s100.00
$130.00
s300.00
$ 40.00
$
$
s
s
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
'ne Ci rcui t ,/-- S 35 .00
Each Addi tional
Circuit or vith Service
or Feeder Permit $ 2.00
STIBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
sign/outline Lighting- S 40.00
Liilited Energy/Res -- $ 20.00
-fi.'"
B
5
RECEIVED
dra