HomeMy WebLinkAboutPermit Electrical 2002-05-30225F-BTH STREET
SPRINGFIELD, OREGON 9"1477
INSPECTION REQIIEST: 7 26 -37 69
OFFICE: 726-3759
& ELEC- IPERMTAPPLICATION
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Multi-Farrdty per dwe[iqg udt
Se,rvice lncluded:
Items Cost Sum
.: $106.00
-
$ 19.00
$ so.oo _
B. Services or Feeders
Installation, Alterations or
Relocation:
I.rc
J.
A
LEGAL DESCRIPTION
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Permits are non-Eansferable and expire
if work is not started withitr 180 days
ofissuance or ifwork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
1000 sq.ft or less
Each additioual 500
sq. ft or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
200 amps or less
201 amps to 400 arps
401 amps to 600 amps
601 zmrs to 1000 amps
Over 1000 ampsfuolts
Reconnect Only
\t
Electrical
-0
Supervisor License
Expiration 02-
Constr Contr.
Expiration
Signature of Supervising Elec'trician
,
9u aou-prcn"lb[-5b1
YT
g
Nurnber lb$q-gET
C. Temporary
D
amps
amps or 1000 volts see
s 63.00 _
$ 75.00 _
$125.00 _
$163.00 _
$37s.00 _
$ so.oo _
$so.oo _
$69.00
$100.00
L--
Owners Name
o o t r
\4'.7 4rza
00
s $ 3.00 _OWNER INSTALLATION
The installation is behg made on
property I own which is not intended
forsale, leaseorrent
Owners Signatue:Limited Enerry/Res
Limited Energy/Comm
$50.00
$50.00
s2s.00.....-
-
, s45.00 Y >
E.included)
\$
Minimum Electric Pemit Inspection Fee is S45.00 + Surcharges
5. SUBTOTALOFABOVE
7Yo State Surcharge
8% Administrative Fee
Lti
3lfv6t
TOTAL etf
corr*oo, Sontt o{ 9dl
Branch Circuits
New Alteration
One
JOB
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