HomeMy WebLinkAboutPermit Electrical 1999-10-15CITY OF OREGON
225 FTriIx STPGET
SPRTNGFTELD, OREGoN- 97
iusppctroN itnQuest tD"t?
Zoning
477
OFFICE: 726-3759 nuthorizedSignature
1 LOCATION OF
IJGAL DESCRTPTION 0'/3
JOB rL
2.INSTALI..ATION ONLY
Electrical t rac tor
fhe lollowing Prolect as submitted has the lollowing
zoning, and does not
approval
require sPecific land use
B.
EIJCTRICAL PERHIT APPLICATION
Ci ty Job Nunber ?? /.t ZL/
A.
COHPI.,ETE FEE SCEEDTII,E BELOV
Nev Residential-Single or
HuIti-FamilY Per dvelling unit'
Service Included:Items Cost Sum
Permits are non-transferable and expire
ii-""it is not started vithin 180 days
of issuance or rf vork is suspended for
180 daYs.
Each additional 500
sq. ft or Portion
thereof
Each Manuf'd Home' or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amPs or less
'201 amPs to 400 amPs
-
$ 8s.00
$ 1s.00
$ 40.00
ee
.00
.00
.00
"Bl a56IG-
Address
Ci
Ci ty
Supervisor License er
Expiration Date,
Constr Contr. Number,
Expiration Date
Signature of Supervising Electrician
Ovners Name
Address '3{)
DATE:
401 amPs to 6 00 amPs
601
\S aIIa t ion ,
PER\OD
000 amps-
/vo1 t s
ces or Feeders
Alteration or Re location
$ s0.00
s 60.00
$100.00
s130.00
$300.00
$ 40.00
crry ff/Ftf Phone 726*/755
OSNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
ior-sa1e, lease or rent'
0mers Signature:
Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit t $ 3s'oo t-
Each Additional-Circuit or vith Service ^or Feeder P..,ni,'=")- $ 2'oo L
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sisn/OutIine Lighting_-
Liilited EnergY/Res
-
Limited EnergY/Comm
' 2OO amPs'"or less
201 amPs to 400 amPs --Over 401 to 600 amps
-
Over 600 amPs or 1000 volt
SUBTOTAL OF ABOVE
7% State Surcharge
32 Administrative Fee
TOTAL
40
55
80
$
s
$ss
D
E
s
$
$
$
40
40
20
36
00
00
00
00
37-ffi-
RECEIVED
5
a -J
ffi
-1-