HomeMy WebLinkAboutPermit Electrical 1992-08-075I'IItNGFIELf,,
225 FIFTB STRBEf,
SPRINGFIEID, OREGON 97477
INSPBCTION RBQTIBST.. 726_37
oFFICE: 726-3759
1.OF INST
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. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
Ci ty Phone
Supervisor nse Number
PERHIT APPLICATION
City Job Number
FEB SCHEDULB BBLOV
Nev Residential-Single or
HuIti-FamiIy per dvelling unit.
Service fncluded:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ Bs.oo
$ 1s.00
$ 40.00
Services or Feeders
fnstallation, Alterations or
Relocation:
200 amps or less
401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
tne lt",,OWing project asacnin0, and doesnot reguil'o specificapproval,
A
$ub.mitted iras the Ail
rffifl'1CD
fNf,tTffiTj
Sum
B
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Expiration Date
Constr Contr. N
c
umber
Expiration Date
Si ture of srng tri :rn
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
Over 401 to 600 amps _ $ 80.00
0ver 600 amps or 1.000 volts see I'Brr above
Owners Name
Address
citv6f,A tN Phone
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one ci rcui t -t- S 3s. oo 35Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each ins tallat ion
Pr.rmp or irrigation
Sign/0utIine Lighting-
Limi ted Energy/Res
Limited Energy/Comm
STETOTAL OF ABOVB
5Z State Surcharge
TOTAL
,;Jil,I*,'*
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0vners Signature:
DATE:
RECEIPT *:
$
$
$
$
40.00
40.00
20.00
36.00
5 ao-
RECEIVED B