HomeMy WebLinkAboutPermit Electrical 1991-12-18C'TY onEGorv
51' TGFIELO
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225 FIFTE S]3BEf,
SPRTNGFTELD, oREGON 97477
INSPBCf,ION REQUBSTz 726-3769
OFPICE: 726-3759
LEGAL DESCRIPTIONtl023/'f,Olooo
JOB DESCRIPTION
Permits are non-transferable and expire
lf vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COI|TRA TOR INSTALI,ATION ONIY
BLBCTRICAL PERHIT APPLICATION
Ci ty Job Nunber
3. COHPI,ETB PBE SCEEDULB BBLOS
A. Nev Residential-Single or
HuIti-FamiIy per dvelling unit.
Service fncluded:
Items Cost
1000 sq.ft. or less $ 85.00
rach additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd Home or
-Modular Dvelling
Service or Feeder S 40.00
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less t '1
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Sum
Electrical Contractor
Address
Ci ty ?^r"t^a phone
An*- ?Ln-
Supervisor License Ntimber
Expi ration Date
Constr Contr. Number
Expiration Date )) ru Ir, >
Signat o ising Electrician
0vners Name
Address q
50-co
200 amps or less $ 40.00
Over 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see I'B" above
11 ,-l
$ s0.00
$ 60.00
$100. 00
$130.00
$300.00
$ 40.00
o-
ciry ?l t c,t*J-qt\ffn.
0
O}INER INSTALI^ATION
The installation is being made on
property I ovn which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:,)
RBCEIPT
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
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/outline Lighting- $
Limi ted Energy/Res $
Limi ted Energy/Comm S
STIBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
40.00
40.00
20. 00
36. 00
r,
RECEIVED BY:E.
5 oo
1. LOCATION OT INSTALI,ATIONbt-t^ u ?z^&-