HomeMy WebLinkAboutPermit Electrical 1996-11-20CITY OF
SP/ -;FIELlf
The loilowing Project
zoning, and does nor
apiloval'
as e ubmittecl hac tho
roquire specilic laftir
,hfr,
amDs
r 1000 volts
225 FIFTE STREET
SPRINGFIELD, oREGoN 97 417
fNSPEOITON REQTEST: 726-3
OFFICE: 726-3759
ELECTRICAL PERHIT APPLICATION
City Job Nunber Qo
3. COHPI..ETE FEE SCffiDTJLE BELOS
Nev Residential-Single or
Multi-FamilY Per dvelling unit'
Service Included:Items Cost
1000 sq.ft. or lbss
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less I
201 amps to 400 amPs
-
401 amps to 600 amps
-
60L amps to L000 amPS-
0ver 1000 amps/vo1ts
-
Reconnect OnlY
Zo
c)/
7B$o
Authorizod
1 LOCATION OF INSTALLATION
l=rL t...)l bY4
I..EGAL DESSRTPTION
Permits are non-transferable and expire
if vork is not started vithin 1"80 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B
Elec tricaI Con tractorUl. L.-LctF. =fft)/tCE
eddress P6 Aav so
ci ty tluaei:t: firltN phone 343 - | b8l
Supervisor License Number /J4A-r
Expiration Date /O - t -49 C
Constr Contr Number -\tOO
Expiration Date 4-t+ -oo
Si ture of SuPervising Electrician
Ci ty
DATE:
Temporary Services or Feeders
Insiallation, Alteration or Relocation
A
Sum
200 amps''or
20i. amps to
Over 401 to
0ver 600 am
I
4
6
PS
s s0.00
s 50.00
s100. 00
s 130. o0
s300.00s 40.00
$ 40.00
$ ss.00
$ 80.00
see r?Brl
psam
ses
00
00
o
5" *'-
aEove
O.p D. Branch Circuits
0vners N.ru Nev, Alteration or Extension Per Panel
Address a\5-t:)l-/rt4oO $ 3s. oo
F' --.r- q:{ol Phone
One Circui t
Each Additional
Circuit or vith
or Feeder Permit
Servi ce
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
$ 2.00
E. MisceLlaneous (Service/feeder not included)
Sr,,*
-Each i.ns tallation
Pump or irrigation _-
Sign/0ut1ine Lighting--
Limited EnergY/Res
-_Limi ted EnergY/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAI
(
s
$
$
40.00
40. 00
20.00
36.00
so
RECEIVED B
5
,5054*
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