HomeMy WebLinkAboutPermit Electrical 1995-10-04ICITY OF C -{
tn.?,
irl I il[ s_ 1 19iy] as s u.u m inod has rh o foilcwins";rng, and dces nct requi;'o specitic lanci usa
1o1)
200 amps or
201 amps to
401 amps to
SPFlTNGFIELO
to
amps
Only
/voIts
Sum
40.00
55. O0
BO. O0
ee trBtr a6ove-
. ,.: !, <:t.
225 FW"IH STREEI
SPRTNGFTEI^D, OREGON 97 411
INSPECTION REQUEST:, 726-
OFPICE: 726-3759'
37_@eJ^0=+tr
Authcrlzed glgn
1.TION OF INST ON
LEGAL DESCRIFTION
JOB DESCRIPTI
Permits are non-trans ferable and exPire
if vork is not started vithin 180 daYs
d"c ELECTRICAL PERHIT APPLICATION
Ci ty Job Number
COHPI,ETE FEE SCMDULE BELOIT
A Nev Residential-Single or
MuIti-FamilY Per dvelling unit'
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Sertice or Feeder
$ 8s.00
s r.s.00
$ 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
less
600 amps
1000 amps
iu',ln
of issuance or if vork is susPend
180 days.
2. COI{TRACTOR INSTALI.ATION ONLY
Electrical Contractor b
Address gs NG
ed for
3 00
00
00
00
00
00
ss0
Soo
s100
S130
s300
s40
$
$
s
s
s 40.00
$ 40.00
$ 20.00
s 36.00
€a
Ci ty Phone 6B
Supervi sor License Number
Expi ra t ion Date I o^?6
Constr Contr. Number O
Exp iration Date c
Temporary Services or Feeders
Installaiion, Alteration or Relocation
601 amps
Over 1000
Reconnec t
Signature Supervi
0vners Name
Address
Ci ty
OVNER
'?fr -rr^.1{r,izG
200 amps"or less
201 amps to 400 amPS
-
0ver 401 to 600 amPs
Over 600 amPs or 1OOO voTEs
SUBTOTAL OF ABOVE
52 State Surcharge tz
3Z Administrative Feef, t
TOTAI
1
trician
c.
D
E
Phone
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 3s.00
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0ut1ine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent'
0vners Signature:
DATE:
RECEIVED
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5.-?
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