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HomeMy WebLinkAboutPermit Electrical 1997-12-15SPRINGFIELD, OREGON' 97 d+77, : - .:: . : ., inspsmroN REQUEST z 726-376'9 OFFICE: 726-3159 SPr. rrgFlELD i EI,E.CTRICAL PERHIT APPLICATION q city Job rt^u., 77/272225 FIFTE STREET Z,:,,;.",;-- \d t' l**-fu_ql Oru 1. LOCATI OF STALLATION LEGAL DESCRIPTION e-\ JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALL\TION ONLY Electrical Contractor Add ress Ci. ty Phone Supervi s,:lr Li cense Number COMPLETE FEE SCHEDIJLE BELO\I Nev Residential-Single or MuIti-FamilY Per dvelling unLt Service Included: I tems 3 A Expir:ation Date q.ft. or less ddi tional 500 t or portion of anuf'd Home or ar Dvelling ce or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less / 201 amps to 400 amps -401 amps to 600 amps _60L amps to 1000 amps_ 0ver 1000 amps/vo1ts Reconnect 0n1y SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL 1000 s Eacl-r a sq. t there Each M ModuI Serv i <,. Cos t $ 8s.00 $ 15.00 $ 40.00 s s0.00 s 60.00 $100. 00 $130. 00 $300.00s 40.00 not 40. 40. tu. 36. Sum aEove _z-" B Constr Contr. Number Expiration Date Signature of Supervising Electrician 0nners Name Add ress 3t Ci ty si & Phone s-f-t- qk/-)s?3 OTTNER TNSTALK\TION The installation is being made onproperty I ovn vhich is not intendedfor sale, lease or rent. 0vner DATE:Qt Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"or iess $ 40.00 201 amps to 400 amps - S 55.00 over 401 to 600 amps - $ 80.00 0ver 600 amps or 1000-tofTs see "B" /-\ , C.\ D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional- Circuit or vith Serviceor Feeder Permit g 2.00 Miscell-aneous (Service/feeder -Each installation Pump or irrigation $Sign/Outl-ine Lighting- $Limited Energy/Res - $Limited Energy/Comm $ included ) 00 00 00 00 5 *O RECEIVED BY: ture: *> t a