HomeMy WebLinkAboutPermit Electrical 1995-08-10225 FIFTE STREET
SPRINGFTELD, OREGON 9 7 477
ize=ltu 9' . t' :t'INSPECTION REQUEST:
OFFICE: 726-3759
1. LOCATION OF TION
DESCRTPTION
JOB DESCRTPTION
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Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALLATION ONLY
:it-l]rlW-FtELD
ELECTRICAL PERHIT APPLICATION
Ci ty Job Nunber
COHPIJTE FEE SCBEDTILE BELOS
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Sertice or Feeder
s 8s.00
$ 1s.00
B
200 amps''or less
201 amps to 400 amPS
-
Over 1101 to 500 amps
Over 600 amps or 1000-ioTts
D. Branch Circuits
Nev, Alteration or Extension Per Panel
Each Additional
Circuit or vith Service
or Feeder Permit
-
S 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/Out1ine Lightirg_
Limited Energy/Res
Limi ted Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
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1
g. p roJ e.:r as su.bmlttect has f ho followingz\)r)i.li, i.,rd rtoes irot roquire spocilic i;;;;;""',af Pt;v ul
h
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Z
INSTALLA2 t-f
,
A.
Sum
s 40.00
Electrical Cont ractor ,4 0/f 6a5o
Services or Feeders
Installation, Alterations
or Relocation:
I
Address f.fll fi,oir"v 200 amps or less
201 amps to 400 amps
-401 amps to 600 amPs
-
601 amps to 1000 amps-
Over 1000 amps/volts
Reconnect Oniy
Ci ty tF,r. o phone ?ZZ 620/
Supervisor License Number 7 a735
Expiration Date
C
Constr Contr. Number 1 >f o 6 Temporary Services or Feeders
Installation, Alteration or Relocation
$
s
$
s
$
$
00
00
00
00
00
00
Eovea
s 40.00
s ss.00
s 80.00
see ItBrt
50.
60.
100
130
300
40.o / 7t
Expiration Date
Signature of Supervising Electrician
0vners Name
Address h
Ci tv Phone
OIINER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
E
$
s
$
s
40.00
40.00
20.00
36.00
/,os
3 730RECEIVED BY:
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