HomeMy WebLinkAboutPermit Electrical 1996-08-08/ t' rrr)!, and does not r€qulre ep€cific lend uce
€':;'lr; OV9l.
zoniry LB(---
,,-,,_8.|L, ell
SPCI
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
fit,ril
7 Ets.tfl
225 FrFTH STREET ...:.: ,:il:eil
SPRTNGFTELD, 0REGON 97477
INSPECTION REQUEST: 726-3769
oFPICE: 726-3759
1. LOCATION F INSTALI^ATION
I,EGAI
JOB
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
L80 days.
2. CONTRACTOR INSTALLATTON ONLY
El-ectrical Contractor
Address
Ci ty ne
Supervisor ense Number
Expiration Date S
Constr Contr. Number
Expiration Date
si rv Electrician
\rt=rn-,----
Ovners Name
Address
EI^ECTRICAL PERHIT APPIJCATIO'T\
.
City Job Nunber
3. COHPI.^ETE FEE SCMDULE BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
s 40.
s ss-
s 80.
s see tt
Sum
00
00
00
B" a6ovE-
z $ Bs.oo /zo.H
s 40.00
B Services or Feeders
Installation, Alterations
or ReLocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
s s0.00
s 60.00
s100.00
s130.00
s300.00
$ 40.00
C
200 amps''or fess
201 amps to 400 amps _Over 401 to 600 amps
Over 600 amps or 1000-toIT
D. Branch Circuits
Nev, Alteration or Extension Per Panel
city-Phone 7/7-?zlz
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent'
0vners Signature:
DATE:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lighting.--
Limited EnergY/Res
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
@
/o oo
s 3s.00
s 2.oo
s 40.00
s 40.00
$ 20.00
s 36.00
RECEIVED
5
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