HomeMy WebLinkAboutPermit Electrical 1998-04-13S}
^I(iFTELO
zoning, and
approval.
itot rcqulfe sp€crflc land uoo
225 FIFTII SI'REBT
SPRTNGFTELD, 0REGON 97
INSPECTION REOUEST:
0FFICB: 726-3759
1. LOCATION OF IN
LEGAL PTION
3
A
BLECTRTCAL PERHTT APPLTCATTON
City Job ffrrmf;g.r
COHPLETE FBE SCEEDULE BELOII
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:ry
Pernrits are non-transferable and expireif work is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
El-ectrical Con tractor
Address Bgq
Phone @"-OIOS
Supervisor License Number I 568 5
Expiration Date o
Cons t r con t r . Nurnber 5Ll+3 I
Expiratiotr Date
S f Supervi s EIec trician
0wners Name
Address 5r b tbtz--
Ci ty Phone 7)G - Ot L
OIINER INSTALLATION
The installation is being made on
property I own vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
ft or portion
thereo f
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder
B. Services or FeedersInstalIation, Alterationsor Relocation:
200 amps or less
20L amps to 400 amps
40L amps to 600 amps _60L amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0n1y
C
D
E
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
Temporary Services or Feeders
Installation, Alteration or Relocation
I tems Cos t Sum
$ 8s.00
s 1s.00
$ 40.00
s s0.00
$ 60.00
$100.00
$i30.00
$300.00
$ 40.00
/e o-L
g
aEoiil
not ineluded)
40.00
40.00
20.00
JOB DBSCRI.3u v
PTION sq.
add
ft. or less
i t ional- 500
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
200 amps or less
201 amps to 400 amps -0ver 40L to 600 amps
Over 600 amps or L000-volTs
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $sign/outline-Lighting-- $
t imited Energy/Res
-
$
Limited Energy/Comm S
$ 40.00
$ 5s.00
$ 80.00
see ttBrt
5
RECEIVED
ooo
Rosr G rpororio-r..-
ciwbuqe_he,
-