HomeMy WebLinkAboutPermit Electrical 1999-04-29C'TY OF
IGFIELE,
The lotlowlng
zonlng' ano I
approval
'fJ:S::iH3'Bi"'*ft i"'H"t'l,"S*
LD f\_-225 FIFTE STREET
SPRINGFIELD, OREGON 97
INSPECTION REQUESFate
OFPICE: 726-3759AutrroriZed Signature
q ELE TRTCAL PERHIT APPLICATION
City Job Nurnbe, 4?0q1/
3. COMPI,ETE FBE SCEEDTILE BELOV
A Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
I tems Cos t
$ 8s.00
4flins
1. LOCATION OF?zz I 3
I,EGAL DESCRTPTION
t t0?0rz 6tt?3 &Sum
1.80
2.
ci ty-Ph
Supervi.sor License ber
Expiration Da
Constr Co . Number
Expi ra on Date
Signature of Supervising Electrician
r Ovners Name trt/hr/o/ttl
Address fzl i 37 y'/
ciry5tut[4 Phone 7tl'7Cfl
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-40L amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/volts
Reconnect Only
C.Temporary Services or Feeders
Installation, Alteration or Relocation
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular DveIIing
Sertice or Feeder
D. Branch Circuits
JOBctn
Permi ts areif vork isof issuancdoB0w
ON
to
rules by
s 1s.00
.00
.00
s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
s
$
$
s
s 40.00
s 40.00
$ 20.00
s 36.00
200 amps''or Iess
201 amps to 400 amps _
Over 401 to 600 amps
Over 600 amps or 1000-vo-ITs
40
55
80
a661iil
.00rBree
Nev, Alteration or Extension Per Panel
one tcircuit / $ 35.00 3f
r."nteaJiiionar
Circuit or vith Service , z-T
OVNER INSTALI"ATION
The installation is being made on
property I ovn vhich is not intended
for saIe, Iease or rent.
Orners S
DATE:
l'
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/OutIine Lighting_
Limited Energy/Res
Limi ted Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Admini.s trative Fee
TOTAL
37,au5
RECEIVED B
ture:
t. cr
rn OAR ot the
Electrical
Address