HomeMy WebLinkAboutPermit Electrical 1991-11-07CITY OF SPRINGFIELD,OREGO'V
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1. LOCA ON OF INSTALI-ATI
DESCRIPTIQN 7 >L7 0
JOB DESCRIPTION
2. CONTRACTOR INSTALI,ATION f
Permits are non-transferable and expire
if vork is not started vithin 180 days
;; i;;;..ce or if vork is susPended for
180 days.
225 FTYTH STREET
SPRINGFTELD, OREGoN 97477
INSPECTI0N REQIIEST: 726-
OFFICE: 726-3759
Ovners Name
Address
COMPLETE FEB SCMDULE BELOV
Nev Residential--Single or
Multi-FamilY Per dvelling unit'
Service lncluded:Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Manuf'd Home or
Hodular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
B. Services or Feed
)ArlhuEsd
3
A
Ofioo Sum
r i{:i tallation, A1
10n:
the l9u to
ers
terat i ons
amps _
amps _amps_
UI
ElectricaL Contractor
Address P.O. Box 21009 0ogo:
City E uqene Phone 4
Supervisor License Number
Expiration Date
Constr Contr . Number 65149
Expiration Date 6-28-00
Signature Su sing Electrician
Temporary Services or Feeders
rnsiallaiion, Afteration or Relocation
200 amps or fess $ 40'00
o""r +bl to 600 amfs -
-
S 80'00
0ver 600 amps or 1O00ETts see rrBrr above
Branch Circuits
Nev, Alteration or Extension Per Panel
Tn 00
00
00
$s0
S60
$1oo
t-001 o
obtarn
I
c
v
$130.00
s300.00
$ 40.00
?G17j
RM D.
WORK
THIS PERMIT IS NOT
IFTHE
Phone
One Circuit
Each Additionaf
Circuit or vith Service
or Feeder Permit
$ 3s.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Out1ine Lighti.g--
Limited EnergY/Res
--Limited EnergY/Comm
Ci ty
OVNER INSTALLATION
The installation ls being made on
prop"tty I ovn vhich is not intended
tor sale, Iease or rent'
Owners Signature:
s
$
$
$
00
00
00
00
40.
40.
20.
36.
5 SUBTOTAL OF ABOVE
52 State Surcharge
3% Administrative Fee
TOTAL
DATE:7
RECEIVED B
lt,
.rT\
BLE TRICAL PERI{IT APPLICATION
city Job N,*b", rE /17 /
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