HomeMy WebLinkAboutPermit Electrical 1999-04-06The fOllowing project as submitted has the fal S
zonlng, and does not require specific land t}*.
Date
AuthoriZZbsEttlrf,
SPRTNGEIELD, OREGoN 97477
INSPECf,I0N REQITBSTz 726-3769
oFFICE: 726-3759
1 LOCATION OP INSTALI,A:TIONq h!^,
LEGAL DBSCRTPTION
6D
JOB DESCRIPTION
iHAIL qXPIRE IFTHE WfRK
s ,ricrlslo
EIACTRICAT PEru{TT APPLICATION
City Job Nunber ?= o 4s-7
less s 8s.00
1 500
t ion
$ 1s.00
Home or
r Dvelling
Service or Feeder $ 40.00
llQ Dfilrrr-p 1r .JT
Notification Center. fhose
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
i OAtl 95?-001-0010 thro
Permi ts a
if vork i
of issuan
180 days.
Electrical Contractor
Address
callire non-transferab
s not started vi
ce or if vork is suspen
btain
r. (Note
B. Services or Feeders
fnstallation, Alterations
or Relocation:
200 amps or less
20L amps to 400 amps
-40L amps to 600 amps
-601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0n1y
5. SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
\
2. COMRACTOR INSTALI,ATTON ONLI
<r
City fr rc*e,rr_ Phonel(sr-l^551!lo
Supervi sor License Number 431,-:rrG
s s0.00
s 60.00
$100.00
$130. 00
s300.00
s 40.00
s 2.00
Expiration Date \D-C \,-qq
Cons tr Contr. Uumber \ \ \
-]rkLP C" Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less S 40.00
over 401 to 6oo amps
-
$-Bo.oo -
Over 600 amps or 1000 voTts see uBu a66E
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit
Expiration Date
Signa ture of Supervising Electrician{rr
Ovners Name
Address ?"0 ,(
Ci ty Phone bgu _qral
O9NER INSTALI,ATION
The installation is being made on
property f ovn vhich is not intended
for saIe, lease or rent.
Ovners Signature:
DATE
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _ $ 40.00
SignZOutline Lighting_\_ $ 40.00 "T..-Limited Energy/Res _ $ 20.00
r)A- OA -a\t
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CITY OF SPF'A'GFIEL OREGON
RECETYED
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