HomeMy WebLinkAboutPermit Electrical 1998-11-03SP...r\TGFIELD
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225 FIFTE STRXET
SPRINGFIEI.,D, OREGON 9
INSPECTION REQIIEST:
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ELECTRICAL PERHTT APPLICATION
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3. COHPLETE FEE SCEEDUI,E BELOIJ
A Nev Residential-Single or
MuLti-Family per dvelling unit.
Service Included:
I tems Cos t
B. Se
Installation, Alterations
or Relocation:
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rv 1-s o License Number
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I.EGAL
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DESCRIPTI
Permi ts 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 INSTALI,ATION ONLY
Electrical Contractor
Address
Sum
200 amps or 1
201 amps to 4
401 amps to 6
601 amps to L
Over 1000 amp
Reconnect 0n1
ess Y00 amps
00 amps
000 amps_
,s /voI ts
v
50
60
100
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5
4
4
2
3
s
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$
s
s
$
$
s
$
s
00
00
Ci ty
Supe
130.00
300.00
40.00r
Expiration Date
Constr Contr. Number
Expiration Date
S of p I Electrician
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D. Branch Circui ts . ..
Nev, Alteration or Extension Per Panelovners Name T't- 'C, //r'
Address 281 7 C/^*,/ a<
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OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0rners Signature:
DATE: /t
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one circuit $ 35'oo
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
MisceLlaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting-
Limited Energy/Res
Limited Energy/Comm
0.00
0
0
6
00
00
00
5
RECEIVED BY:
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requires
rules are set forth
dota8l telePhone
UtilitY
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
D L-)-1
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