HomeMy WebLinkAboutPermit Electrical 1995-01-17CITY OF SPP'A'GFIELD, OREGON
The as
zoning, and does
approval.
not require sPecific land use
225 TIFTE SIREET Zoni /+L
SPRINGFTELD oREGoN 97477 /<t -lr-
INSPECTION REQIESTz 726-37
OFFICE: 726-3759
1. LOCATION OF INSTALI.,ATION
3 3% fuq{h L/ "< 3t'
LEGAL
1
JOBr/
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COI{ITAgIOR INSTALI.,ATTON -ONLY
SPRIT{GFIELD
Upt
3. COUPI^ETB FBE SCEEDTILE BBLOII
ELECTBICAL PERUIT APPLICATION
city Job N,^b"..q 5W(-L t-
A
B.
c.
New Residential-Single or
Multi-FamiIy per dvelling unit.
Service Included:
I tems Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Moddlar 'Dvellirrg
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
$ 40.00
50.00
60.00
100.00
130.00
300.00
40.00
40.00
5s. oo
BO.0o
ee ilBr a66lriil
Cos t
$ 8s.00
s 1s.00
Electrical Contract
Ci ty
Supe
ea
Address &q 3r s2-200 amps or less
201 amps to 400 amPs
-
401- amps to 600 amPs
601 amps to 1000 amPs-
Over 1000 amps/voIts
-
Reconnect 0n1Y X
Temporary Services or Feeders
Installation, Alteration or Relocation
rvlsor cense Number
Expiration Date
Constr Contr. Number
Expiration Date
Signa ture of
200 amps or less
201 amps to 400 amPs
-
0ver 401 to 600 amPs
0ver 600 amps or 1000-ioFs
$
$
$
$
$
s 4m
Electrician
s
$
$
s
t!
Ovners
Address
Ci Y1
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Orners Signature:
DATE:
D Branch Circuits
Nev, Alteration or Extension Per Panel
one Circuit $ 35'00
Each Additional
Circuit or vith Service
oi Feeder Permit $ 2.00
E Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
L{,l'1^
one
OIJNER ON
s 40.00
$ 40.00
$ 20.00
s 36.00
5
L
RECEIVED
l.zo
=q?' 20
t1
Phone
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