HomeMy WebLinkAboutPermit Electrical 1996-01-10CITY OF OREGON
S"}tI}.'GFIELE}
not require sPecitic use h,
ipproval'ru-
225 FIWE SII.EET
SPRINGFIELD, OREGON 97fr[f,onzod
INSPECTION REQIIESTz 726-3769
OFFICE: 726-3759 3. COUPLETE FEE SCMDIILE BELOV
A. Nev Residential-Single or
llufti-f"ri1Y Per dvelling unit'
CN-PERHIT APPLICATION
Ci ty Job Number
q
Service Included:
\
1. LOCATION OF ON
au
180 daYs.
Z. CONTRACf,OR INSTALI.'ATION ONLY
Electrical Contractor 6 4 fKL
///tg, n/
if
of
rmits are non-transferable and^expire
vork is not started vithin 180 days
;;;;.;;" or if vork is susPended for
1000 sq.ft. or less
nach additional 500
sq. ft or Portion
thereof
Each Manuf 'd llome' or
l{odular Dvelling
Service or Feeder
Services or Feeders
instattatiot', Alterations
or Relocation:
200 amPs or less /
lo1 ambs to 400 amPS .-
aOl- ambs to 600 amPS
-
601 amps to 1000 amPs-
or"t ibOO amPs/volts --
Reconnect 0n1Y
B
I tems Cos t
$ Bs.oo
$ 1s.oo
$ 40.00
Sum
-fczo O
Address
Ci tY 5 n f o Pho ne 22/
Supe rvisor License Number 3 o2-36
Expiration Date 2 ?(
Constr Contr' Number 7>-5 o6
Expiration Date ?6 (
TemporarY Services or Feeders
Installation, arieration or Relocatlon
200 amPs''or less
201 amPs to 40u amPs
-over 401- to 600 amP! ------6r.i ooo amPs or 1o0o vorts
Branch Circuits
Nev, Alteration or Extension Per Panel
-tr/s so.oo
s 60.00
$100.00
$130.00
$3oo. oo
$ 40.00
(zo )
C
77 r 6 7,1/ , /
.00
.00
80.00
ee trBtt above
$ 3s.00
$ 2. oo 6P9
er not included)
One Circuit
Each Additional.-Eit"uit or vith Serv:'ce,
or Feeder Permil '/
I,lisceIlaneous (Service/feed
-Each instaflatron
Prtmo or irrigatron
iin'"zouttine Li ght ing-
ilili t"a EnergY/.Res
-
ii*it"a EnergY/comm
40
55
$
$
s
s
S ture of SuPervising Electrician
D
t-o"/(rs Name
dress
Ci tY r //2 Phone /6 o?21
OVNER INSTALLATION
The installation is being made on
Droperty I ovn 'i'-i"aft'1"
iot intended
["i'".rl, ]'ease or rent '
Ovners Signature:
E
s 40.00
s 40.00
$ 20.00
-
s 36.00
D
5 SUBTOTAL OF ABOVE
5% State Surcharge
i7 aJ*l"lstrative Fee
TOTALDATE:
BRECEIVED
f6
zoning'
7
the
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