HomeMy WebLinkAboutPermit Electrical 1997-03-17SPFII{GFTELD
gl 477 ic,r,i,'..,.: .__-- -._
72tu3769
ELE TRICAL PERHTT APPLICATION
City Job Nuuber
AiJtr r!', rruo 3r;ii:.1-u re.- *_---_3 -._-coupIJTE,.FEE scmDIIIJ BELoII1. LOCATTON OF TNSTALLATTON8rN 2 Eitt'a
225 FIFTH STREET
SPRINGFIELD, OREGON
TNSPECTION REOTIEST:
OFFICE: 726-3759
g'ffilr\-o TqcO
JOB DESCRTFTTON
3eP.*,tc-€ c C-
Address \'tZ N ZC w?,
city $Phone -tLtl -H"q I
OIINER INSTALLATION
The installation is being made on
property f ovn which is not intended
for saIe, lease or rent.
Owners Signature:
DATE:
A. Nev Residential-Single orMulti-Family per dvelling unit.Service fncluded:
f tems Cos t
L000 sq.ft. or less $ 85.00Each additional 500
IYff
o
$ 1s.00
$ 40.00
s s0.00
s 60.00
$ 100. 00
$130.00
$300.00
$ 40.00
@=
Sum
2. cONTRAcrOR TNSTALLATTON 0NLY B. services or Feedersb- Zznc Installation, AlterationsElectri cal Contr actor Euoe+le LlezrelcSac, lNc or Relocation :
Address , Zrr Ltnlrzi^re Sr
City fiu6gdp ,6A Phone 3q4 -ZStot. cnqoz
Supervisor License Number lOciZS
Expiration Date lD.l qr
cons tr contr. Number Q ozoo
Expiration Date
Signature of Supervising Electrician
sq. ft or portion
thereo f
Each Manuf,d Home or
-
Modular Dvelling
Service or Feeder
200 amps or less I
201 amps to 400 amps
-40L amps to 600 amps
-60L amps to L000 amps-
Over 1000 amps/volts
-Reconnect 0n1y
Permits are non-transferable and expireif vork is not started vithin 180 diysof issuance or if vork is suspen-ded for
180 days.
ovher's n^ .B*c*^t-+ l&a-nty
c Temporary Services or Feeders
fnstallation, Alteration or Relocation
D. Branch Circuits
Nev, Alteration or Extension Per Panel
)_Le
E Miscellaneous (Service/feeder not included)
-Each installation
200 amps or less $ 40
201 amps to 400 amps
-
$ 55
0ver 401 to 600 amps
-
$ B0
Pump or irrigation S 40
Sign/0ut]ine Lighting- $ aO
Limited Energy/Res $ 20
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit 3 $ 2.00
.00
.00
.00
,f U*JA*bj Over 600 amps or 1000 voTTs see rrBrr aE6id
00
00
00
Limited Energy/Comm $ S0
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTALRECEIVED
5
00