HomeMy WebLinkAboutPermit Electrical 1999-02-17C'TY OF SPF OREGON
SPFfIT{GFIELE,
CAL PERHIT APPLICATION
225 FTYTE STREET
SPRTNGFTELD, OREGON 97477
ixipecrroN REoUEST ' r26-37we
C
oFFICE: 726-3759
1. LOCATTON OF INSTATLA
b Nunber
arlthorized Signature COHPLETE SCEEDIILE BELOS
Nev Residential-Single or
Multi-FamilY Per dvelling unit'
Service Included:Ttr '6 rq 0c
JOB ON
Permits are non-transferable and expire
i f vork i s no t s tar ted vi thin 180 days
;i i;;;.rce or if vork is susPended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
ELectrical Contractor Soni trol Secur i ty
Address P .O. Box 21009
Ci ty Eu ene Phone 46 1 -5678
Expiration Date rcl
Constr Contr Number 65 1 49
Expiration Date 6-28-00
Signa of ising Electrician
Owners
Address
Ci Phon"J-lrSlafp
OVNER
'LA
.orl-
Items Cost
ess $ 85.00
500
Sum
ru-@
10004
B. Servi
fns taIla
,rt
tor
t
Supervisor License Number \hffiPtl
40t
601
0ver
or Relocation:
200 amps or less
iot .rb" to 4oo amPs
-to 600 amps _000 amps_
/voI t s
Rec
eeders
Ins ta 10n
/s
amps o s
amps to
Over 401 to 600 amPs
Over 600 amPs or 100
Branch Circuits
OEr[s s ee t'Btr a6ove
Nev, Alteration or Extension Per Panel
One Circuit $ 35'00
s;"r, eaaitional
Circuit or vith Service
or Feeder Permit
-
$ 2'00
E. Miscellaneous (Service/feeder not included)
$ s0.00
s 60.00
s100.00
s130.00
s300.00
$ 40.00
C
200
207
D
The install-ation is being made on
piop"rty I ovn lrhich is not intended
ior sale. Iease or rent'
Ovners Siglature:
-Each installation
Pump or irrigation
Sign/Outline Lighting-.
Limi ted EnergY/Res
$ 40.00
$ 40.00
$ 20.00
s 36.00
5 SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
DATE:
RECEI
RECEIVED B
15.00
submited has
specific
l-oca