HomeMy WebLinkAboutPermit Electrical 1996-09-09approval.
Zoni tDL
rirg, and does not requ TA
SPP^ ;'ELt)
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
225 FIFTE STREET Authorized
SPRINGFTELD, oREGoN 97477
INSPECTION REQUESTz 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
LEGAL DESCRIPTION
JOB DESCRIPTI
o*,A--Q;4V
sferable and expire
",",tf, ELECIRTcaL pERHrr APPLTcATToN
City Job Nunber 761
COHPI.,ETE FEE SCHEDTJLE BELOV
New Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
$ 85.00
$ 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
3
A
Sum
P 1 r
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
?.. CONTRACTOR INSTAI,LATTON ONLY
Electrical Contractor
Address
City- Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Exoiration Date
Signature of Supervising Electrician
0vners Name
Address A
Yhone 2/7*%(
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or 1
201 amps to 4
40L amps to 6
601 amps to L
0ver 1000 amp
Reconnect On1
r/?"'
amps _amps_
$ s0.00
$ 60.00
s100.00
$130. 00
$300.00
s 40.00
fE.*
amps
CSS
00
00
000
,s/vo1ts
v
c
200 amps''or less
201 amps to 400 amPs
-
Over 401 to 600 amPs
Over 600 amps or 1000-toTT
$ 40.
s ss.
$ eo.
s see tt
00
00
o0
B" aEovE-
Ci ty
?
OVNER INST
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent'
Ovners Signature:
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35'00
Each Additional
Circuit or vith Service
or Feeder Permit -4- $ 2'00 22.
Misceflaneous (Service/feeder not included)
D.
E
-O
c
-Each ins tal-Iat ion
Pump or irrigation S
sign/outl-ine Lighting- $
t iilited Energy/Res
-
$
40.00
40.00
20.00
36.00
frrte__*_3_Tb_____=-a
}Z_EA
5 SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
DATB:
RECEIVED B
non- t