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HomeMy WebLinkAboutPermit Electrical 1998-11-24CITY OREGiON The {ollo'/r:rc r:,rniec1 a8 suhmkt€d hstpfuIufE ,i,,i,rl,.l u,rl b{;ur fiot roqulro gp€dc kild tEo ai-dIov:Il. sttr,Tt z-imjf,- 7#"f.a19gs8 SP}", .GFIELD ELE TRICAL PERHIT APPLICATION225 FTFTH STR.EBT SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 ffi ffiffi F, ?1""1?"; I I??:5";?iii,"l3 o"53il" E{ S i*ieHffc$i{ ALL EX P{fdfr lf T H EdAIOF#n d e d f o r d,$$rdnmil uFiDEF rHls Pfitilirr l$ i'jcT fr i i,/ ii,ffia[lBaamx$ f;B g'NAilIiuliI 6fir tuul,v CiL".ri".r .6'iif}""tor Son i t ro I secur i tv Address P.O.Box 21 009 Ci ty Eu ene Phone 461 -5678 Supe rvi.sor Li,cense Number l(n&1 RL-I Expiration Date Constr Co ntr. Nurnber 65149 Exp irat ion Date 6-28-00 Signature of Supervising Electrician Ovners Name Address Ci ty Job Nunber FEE SCEEDTILE BELOV Nev Residential-Single or Multi-Famil-y per dvelling unit. Service 1000 sq. Each add sq. ft thereof Each Man Modul-ar Service or Services or Feeders fnstallation, Alterations or Refocation: 200 amps or fess 201 amps to 400 amPs --401 amps to 600 amPS - 601, arnps to 1000 amPS- 0ver 1000 amPs/vo1ts - Reconnect 0n1Y ,+1 00 00 ee rrBtr a6ove 1. LOCA ON Adhortssd INSTAILATION qDE A C E D B $s$6 $10 $13 S30 $4 $ $ $ S $ $ $ s 0.00 0.00 0.00 0.00 0.00 0.00 TemporarY Services or Feeders Insiallation, Alteration or ReLocation 200 amps or fess 201 amps to 400 amPs -Over 40L to 600 amPs - Over 600 amPs or 1000 volts 00 40 55 BO D Branch Cireuits Nev, Alteration or Extension Per Panel one Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit -_ $ 2'00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Light ing- Limited EnergY/Res - Limi ted Energy,/Comm \ SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAL Phone -A{6v/ OIINER INSTALLATION The installation is being made on property I ovn vhich is not intended f or sal-e , lease or ren t ' Ovners Signature: Ci ty DATE 40.00 40.00 20.00 36.00 @D 5 RECEIVED 6