HomeMy WebLinkAboutPermit Electrical 1994-04-07r cl
225 FIFTB STREEI Thstcttov,,'-
SPRINGFIEID' ORBGON 97477 lonlns. r
INSPBCTION REQI'EST: 726-3?WV3'
OFPICE: 726-3759 7 "
Ynone 46/5A79
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.';i,ira sPecific land uee
ag-City Job Nuurber
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1. LOCATION
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LEGAL DESCRIPTIl1 d33q t o900
JOB DESCRIPTTON
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
Z. CONTRACTOR INSTALI,ATION O}TLY
Electrical Contrac tor n1on,- lro I Sa,, r,
Add ress Po- b.*
APPLICATION
HuIti-Family per dvelling unit.
Service Included:
Items Cost Sum
1000 sq,ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular DveIling
Service or Feeder
$ 8s.00
s 1s.00
Services or Feeders
Installation, Alterations or
Relocation:1
Ci ty
Supervisor License Ndmber
Expiration Date
Constr Contr. Number b:r't+9
Exp iration Dat-e 6 -d8-9 h
Signatr;te of Supervising Electrician
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect 0nly
€
B
c
s s0.00
s 60.00
s100.00
s130.00
s300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
Over 600 amps or 1000 volts see "8" above
Ovners Name,
Address
,frL,, O/d An,-
ci ty-Phone 7+1:4e17
OVNER INSTATI^ATION
The instaLlation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE: Lt
RECEIET *:
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Light ing-
Limited Energy/Res /
Limi ted Energy/Comm
SIIBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
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$ 40.00
s 40.00
s 20.00
s 36.00
5
RECEIVED BY:
)n tD,
s 40.00
/71 3
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