HomeMy WebLinkAboutPermit Electrical 1994-05-03,'I a
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225 Flr:fl SINEET
SPRTNGFTELD, oREGoN 97477 .,
IIISPBCf,I0N R80tBsT3 726-3769
oFEICE: 726-3759
The fbllowing projoct as submltted hc the following
zoning, and does not r e qui r e s P e c i i c t a n $1Pg'YA1g 6L
a I
One Ci rcui t
Each Addi t ional
Circr,ri t or vi th Service
or Feeder Permit
SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
APPLTCATION
City Job Nunbe ?<oaz sr
FEE SCEEDULE BELOV
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1 LOCATION OT lorized Signat
5 - , qLl
I.EGAL DESCRIPTION/%z zo b)Q D/7o>
JOB DESCRIPTTON
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. CO}ITRACf,OR INSTALI.ATION OM,Y
Nev Residential-Single or
HuIti-FamiIy 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
Hodular DveIling
Service or Feeder
s 8s.00
s 15.00
s 40.00
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 arps
-401 amps to 600 amps _
601 amps to 1000 amPs_
Over 1000 amps/volts
Reconneet 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
s 3s.00
A
Sum
B
Electrical Contractor
Address / fl. 6D-
€-,oe td- PhoneJ
Supervisor License Ntimber /7/3 J-ZE
ExP iration Date //- /-
constr contr. Number b5 / I q
Expiration Dat-e.d -J8-7Z 200 amps or less $ 40.00
Over 401 to 500 amps _ S 80.00
-
0ver 600 amps or 1000 volts see "B'i above
'/) /)q s s0.00
s 60.00
s100.00
s130.00
s300. 00
s 40.00
C
Signatqfe
/Z;
of Supervising Electri cian
Ovners Name (noerls GdilL
Address
Ci ty
-----J-
oarrl e
Yhone 7/7- 6765
OIINER INSTALI.ATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DA?E:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/outline Lighting-
Limi ted Energy/Res
Limi ted Energy/Comm t
s 2.00
s
$
s
s
00
00
00
00
40.
40.
20.
36.
RECEIVED B
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3t;. ol'80
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