HomeMy WebLinkAboutPermit Electrical 2000-06-30SP-'TIGF]ELE,
CAI PERHIT APPLICATION
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225 FIFTB STRXET
SPRINGFIELD, OREGON 97 417
irripscf,roN PGQI EST: 726-3769
OFFICE: 726-3759 <r
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1. LOCATION OF ALI,A ION
O3zsoo ooZo1
I,EGAL
JOB ON
Electrical Contractor
Address ##l
Ci ty enone e875Vc:
Supervisor License Number vnaS
Expiration Date Cl
Constr Contr. Number,
S I-Single or
ti-1 r dvelling uni t.
Service ed:
1
3
A tNev
Mul
Permits are non-transferable and expire
ii-;;;k is not started vithin 1Bo daYs
of issuance or rf vork is suspended for
180 days. Oo3ql
2. CO}ITRACTOR INSTALI.,ATION ONLY B
1000 sq.ft. or less
nach additional 500
sq. ft or Portion
thereof
Each Hanuf'd Home' or
Modular Dvelling
Sertice or Feeder
Services or Feeders
Installation, Alterations
or Refocation:
Items Cost Sum
$ 8s.00
$ 15.00
$ 40.00
$ s0.00
s 60.00
sr.o0.0o
$130.00
$300 .00
$ 40.00
00
00
00
civ *f &A Phone 1q'7 2?l{
OVNER INSTALI.,ATION
The installation is being made on
DroDerty I ovn vhich is not intended
ior'sall, lease or rent'
0nners Signature:
TemporarY Services or Feeders -in='tirr"iion, Alteration or Relocation
40.00
55.00
80.00
ee rrBrr a56G-
Branch Circuits
Nev, Alteration or Extension Per Panel
onetcircuit L $3s'oo 3{
eacfi additional
CiLcuit or vith Service;i';;;;";-p"i*it- $ 2'oo
' ot included)Mislellaneous (Service/feeder nr
-Each installation
Pump or irrigation
-
sigir/outline Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
SUBTOTAL OF ABOVE
a% State Surcharge
5Z ad*ini.strative Fee
TOTAL
I
200 amPs or less
201 amPs to 400 amps
-
40L amps to 600 amPS
-
601 amps to 1000 lmPs__-
Over 1000 amPs/volts
-
Reconnect 0n1Y
200 amps''or less $
;oi ;;; io qoo amPs
-
i
Over 401 to 600 amPs
-
n
0ver 600 amPs or 1000 volts s
Expiration Date
Signa o
Owners
Address
ing Electrician
c
D
E
$
$
$
$
40
DATE:f:
+.a-f..JH
RECEIVED B
OOO
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W
40
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