HomeMy WebLinkAboutPermit Electrical 1991-08-02SI']IINGFIELft
t
2ip
0
JOB
n
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALI,ATION ONLY
225 FIFTE STREET
SPRINGFIELD, OREGON 97 477
INSPECf,ION REQIIESTz 726-3769
0FPTCE: 726-3759
,TT
ELECTRICAL PERT{IT APPLICATION
Ci ty Job Number
3. COHPLETE FEE SCEEDULE BETOIT
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf,d Home or
Modular Dwelling
Service or Feeder
s 8s.00
$ 1s.00
$ 40.00
B.
L---
Services or Feeders
fnstallation, Alterations or
Relocat ion:
I
200 amps or less I
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps-
Over 1000 amps/volts
Reconneet 0n1y
Temporary Services or FeedersInstallation, Alteration or Relocation
1. LocA
db45 rqHr"ffiB*rroN
Electrical Contractor
eaares"(18 W."Q.'
Ci ty Phone 1 q1,(r(r3g
supervisor License Number f4:33
Expiration Date /0 ,?-
Constr Contr. Number gwq c
Expiration Date l^t$
Signatqre
,/of Supervising Electrician
Sum
5D.oos s0.00
$ 60.00
$100. 00
$130.00
$300. 00
$ 40.00
200 amps or less g 40.00
2oL amps to 4oo amps
-
g 55.00
over 401 to 600 amps
-
$ 80.00
0ver 600 amps or 1000 voITs see uB* aEtE
0vners Name
aaaress,l0
cit Phone w
OTINER INSTALLATION
The installation is being made onproperty I ovn which is not intendedfor sa1e, lease or rent.
Owners Signature:
DATE
D. Branch Circuits
Nev, Alteration or Extension per panel
One Circui t
Each Additional
Circuit or with Service
or Feeder Permit
s 3s.00
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00sign/out]ine Lighting- $ 40.00
Lirni ted Energy/Res
-
S 20. oo
srmrorAl oF ABovB SA,CO5X State Surcharge
TOTAL
D
anD
E
5
RECEIVED
*
I