HomeMy WebLinkAboutPermit Electrical 1999-04-20C'TY OF SPRINGF'ELD, OREGO'V
SP iFIELE,
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
The fotlowing project as submittecl has
zontng. and does not require specificapproval.
, Zoning Pl- o
%
the tollowing
IANd ETECTRICAL PERHIT A?PLICATION
??os z tfatJob Nu-mberINSPEffION REQUEST z 726-316
OFFICE z 126-3759 rare 4->o-
1.
ial
LOCA TION OF INSTALLATIONr\
SCMDULE BELOV
A. Nev Residential-Sing1e or
MuIti-Family per dvelling unit.
Serviee Included:
I tems Cos t
1000 sq. ft. or fess S 85.00
fach additional 500
s4r ortion
UI s 1s.00
fn
i]0."sS 00
17ta!
B.
rules br
On
-800-;s32,
200 amps or l-ess 50.00
201 amps to 400 amps s 60.00
401 amps to 600 amps s100.00
601 amps to 1000 amps_s130.00
s300. 00
,.iuaItOf tZed Signature
LEGAL
JOB DESCRIPTION
Permits are non-transferable and expire
if work is not started vithin 180 days
of issuance or if vork is suspended for
iB0 days
2. CONTRACTOR INSTALLATTON O}ILY
obtwt
Sum
rrgrr u[[u=
35.00
2.00
not included )
rp
Electrical Contracto r Son i t ro I Secur i
n
ty or
Supervisor License Number \(4Q?.ff Over 1000
Reconnec t
E wn i.ration n"r" lo fu
Address P.O. Box 21009
Ci ty Euqene Phone 461 -5678
Constr Contr. Number 651 49
Exoi.ration Date 6-28-00
Slgnature of pervising Electrician
owners tlar"BI-ta n 0o ra
AddressaSS 6t 1
cir Phon"f]c$]{J
OYNER INS TION
The installation is being made on
proper ty,' I oun which is not intended
for saIe. lease or rent.
Orrners Signature:
DATE:
RECEI
-234q.
amps/volts
0n1y s 40.00
Temporary Services or Feeders
Installation, Alteration or Refocation
C
E
200 amps or less
201 amps to 400 amps
-0ver 401 to 600 amps
Over 600 amps or 1000-v6T[s
00
s40sss
SBO
see
00
00
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
One Circui t S
Each Additional
Ci rcui t or vi. th Service
or Feeder Permi t _ S
MiscelLaneous ( Service/feeder
-Each ins tal-Lat ion
Pump or irrigation
Sign/0ut1ine Lighting
Limi ted Energy/Res
Limi ted Energy/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
-r
s
S
S
S
00
00
00
40
40
20
36
5
RECEIVED B
.oo 1%3o