HomeMy WebLinkAboutPermit Electrical 1999-11-15C'TY OF SPR OFEGO'V
!}PFINGFIELD
zonrng and does not require specific land use
'- D R ELEqrRr CAL PERT{IT APPLICATION225 FIFTE STREET
approval
Zoning
SPRTNGFTELD, OREGON 97 477,",^,. __j_L:
INSPECTION REOIESTz 726-
OFFICE: 726-3759
3769
Adthorized Signature
m Qq /sbz------urry Job Numberra-xl
DESCRIPTION
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. COMRACTOR INSTATLATION ONLY
Electrical Contractor
Address /)4)WrTYt fO<-,
ciw F uJ phone 3q+3sb I
Supervisor License Number lMES
Expiration Date fo/or / a /
Constr Contr Number CU ?a2OO
Expiration Date 3/rz/ o t
Signature of Supervising Electrician
0vners Name he
Stsog (raoo
& Phone 7%-Q2(
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent..
Omers Signature:
DATE
r.7 )connr,rrr rrs scEEouLE BELov
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
s 8s.00
sq. ft or portion
thereo f
Each Manuf'd Home or
Modul.ar Dvelling
Service or Feeder $ -40.00
' 1. '' ,,.r
Services or Feeders
InstaIlation, Alterations
or Relocation:
200 amps or less -l-201 amps to 400 amps _401 amps to 600 amps _
9ot t{W8e1090 ?mps_0ver- IUCIU -afiis /vol ts
n e c o ilhllt P EmilI SHALL EXPIH'EI F
5tf-r, )<oO Sum
rerepnon€
NotificatioB
$ s0.00
s 60.00
$ 100. 00
s130.00
s300.00
,w
T$rBU/@(
UNDER S ISNOTC. Te
Ins t tion
ANY 180 DAYPERIOD.
200 amps or less
201 amps to 400 amPs _Over 401 to 600 amps
0ver 600 amps or 1000 voft
D. Branch Circuits
E
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lightirg_
Limited Energy/Res
Limited Energy/Comm
Eove
$ 40.00
s ss.00
s 80.00
see ttBtt as
Address
Ci ty
$
$
$
$
40.00
40.00
20.00
36.00
5. SUBTOTAL OF ABOVE
lEaZ State Surcharge
3Z Administrative Fee
TOTAL
OO
RECEIYED B
/, 5r-'
-rgl oo
)'
1. LOCATT0N 0F TNSTALLATToN ^,385 S, +Pnd /" ,-
2!**J /4.-"-