HomeMy WebLinkAboutPermit Electrical 1999-05-13efi,
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PERHTT APPLrcArr o'4.?o zl 7
225 FIFTE STREET Zoning
SPRTNGFTELD, OREGoN 97 5-t3-INSPECTION REQI.IEST: 7
gFFICE: 726-3759 Authorized Signature
Job Nunber
FEE SCBEDTJLE BELOV
A, Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
1. LOCATION OF INSTALLAT yN-l
12-
rules
2z r N3
JOB DESCRIPTION
Permits are non-tran
if vork is not start
of issuance or if vo
180 days.
2. CONTRACTOR
Electrical Cont
Address bX293 bo*flG€ Ltt.
Si ture of Su rvising Electrician
Ovners Name 0o 0"
Address 6,6
S Phone j 3t-
1000 sq.ft. or less
Each additional 500
ft or portion
f'd Home or
Dvelling
or Feeder
or Feeders
ion, Alterations
tion:
200 amps or less
201 amps to 400 amps __401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/voIts
Reconnect OnIY
-l- s Bs.oo g{
s 1s.00 '/f
s 40.00
I tems Cos t Sum
s s0.00
$ 60.00
$100.00
s130.00
s300.00
s 40.00
LEGAI
t1 f)i'iw;'o* 0 ,f 0o
Ci ty 5r€Q Phone 7q l^ /Y'lg
Supervirsor License Number 3s/V 5
Expiration Date t0- I - ol
Constr Contr. Number ll777O
Temporary Services or Feeders
Installation, Alteration or Relocation
C
Expiration Date )o^ v 11 200 amps''or less
201" amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000-lro-ITs
00
00
00
B" aEJIil
$ 40.
s ss.
$ 80.
sge tt
. City
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Orners Signature:
DATE:
D. Branch Circuits
E
New, Alteration or Exterrsion Per Panel
One Circuit $ 35.00
Each Addi tional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/0ut1ine Lighting_
Limited Energy/Res
Limited Energy/Comm
00
00
00
00
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
/9o
6'rt)
3.7 o
6t
$ 40.
s 40.
$ 20.
s 36.
RBCETVED B
5
/40-a
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