HomeMy WebLinkAboutPermit Electrical 1997-11-10SPT ,FiEL.,
ELECTRTCAI PERHIT APPLICATION
cl7 lboa-,
BELOV
or
tti.-FamilY Per dvelling un it.
Cos t
s Bs.oo
$ 1s.00
$ 40.00
Service Included:
I tems
s 3s.00
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Hanuf'd Home' or
Modular Dvelling
Sertice or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less I
201 amps to 400 amPs _-
401 amPs to 600 amPs --601 amPs to 1000 ?mPs_-
over 1b00 amPs/vo1ts --Reconnect 0n1Y
TemoorarY Services or Feeders -i;lilii;ii"", eii'ration or Rerocation
Zonir la.r
225
SPRINGFIELD, OREGON 97 477
INSPE(f,ION PGQT EST:. 726-3769
OFFICE: 726-3759
THIS PERMIT
AUTHORIZED
COMMENCED
1. LOCATION OF INSTALLATION
4 V0)-Sum2
s,
HSfirif vork
of issu
are non-transferable and exPire
i" not started vithin 1Bo daYs
"n"" or- if vork is susPended for
Address
Ovners Name
Address
Ci tY
OIINER
DATE:
phone tl 4t -AA3ba
t0-l -q8
B.
c
D
Sg-,cc-'$ s0.00
s 60.00
s100.00
s130.00
$300.00
s 40.00
Ci tY
Supervisor '""n"" Number ltrgbS
Expiration Date
Constr Contr' Number ,84q
-t-q8 200 amps''or Iess $ 40'00
;6i il;; ;; tqq ?it: t ii:33
il:: :3b Ho:o:"T83oar" :':';il a566
Branch Circuits ' "
Nev, Alteration or Extension Per Panel
Expiration Date
Signature of Supervising Electrician
Phone - +bA 4
one Circuit
i'""rr"eaii I i ontr
Circuit or vith Servrce
or Feeder Permit .-
Miscellaneous ( Service/ feed
-Each installation
PumP or irrigation
iiniuoutrine Lightittg-
t iilited EnergY/Res --
Limited EnergY/Comm
s 2.00
er not included)
The installation is being made on
Droperty I ovn "ftict' is iot intended
ioi'".rL, lease or rent'
Owners;, Signature:
E.
s 40.00
s 40.00
$ 20.00
s 36.00
SUBTOTAL OF ABOVE
52 State Surcharge
gZ ga*inistrative Fee
TOTAT
RBCEIVED
tq?
5 5e .oo
A, 5o
.1 . s'o
5*' oo
ill
180 days.
2. COI{IBACTOR INSTALI,ATION ONLY
Erectricar contrac."t C tiS €t'-ontnu ',r1.fn-''