HomeMy WebLinkAboutPermit Electrical 1994-11-23C'TY OF ORECON
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SPRINGFIELD, oREG0N. 97 477
rNspEcrroN REOUE;[-!''ii +-g+69il :23- .ct 1
225 FIPTB STREET
OFFICE: 726-3759 Aurhorized
1
ELB TRICAL PERI{IT APPLICATION
City Job Nu.mber
FEE SCBEDTILE BELOS
Nev Residential-Single or
MuIti-Family per dvelJ.ing unit.
Service Included:
o
Cos t
$ 8s.00
s 1s.00
$ 40.00
$ s0.00
$ 60.00
s100.00
s130.00
s300.00
s 40.00
Sri, clO
LOCATION OF INSTALLATIONg oG a1 , -!, r?.
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspented for
180 days.
2.., CO}ITRACTOR INSTALLATTON ONLY
Electrical contractor Jf 6 €Jh^I*.
Address 5
Ci ty Phone 74b 4t 5b
Supervisor L icense Number .3i118 "f
Expiration Date ^o
Constr Contr. Number
Expiration Date 4 -r4-q5
Signature of Supervisi Electrician
I tems
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less ,l-201 amps to 400 amps
-
401 amps to 600 amps
-60L amps to 1000 amps-
0ver 1000 amps/volts
-Reconnect Only
I.EGAL DESCRIPTION
JOB DESCRIPTION
A
5. SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
Sum
c-fuY66
B
0vners Name
Address €
Ci Phone
OIJNER ALLATION
The installation is being made on
property I ovn vhich is not intended
for saIe, Iease or rent.
t
Ovners Signature:
DATE:
C Temporary Services or Feeders
fnstallation, Alteration or Relocation
200 amps or l"ess $
20L amps to 400 amps
-
S
Over 401 to 600 amps
-
$
Over 600 amps or 100016Fs s ee nB, aEoiE
D. Branch Circuits
Nev, Alteration or Extension Per Panel
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0u tline Lighting-
Limi ted Energy/Res
Limited Energy/Comm
One Circuit S 35.00
Each Additional
Circuit or with Service
or Feeder Permit eO- $ 2.00
$ 40.00
$ 40.00
$ 20.00
$ 36.00
qo,o u
40.00
5s.00
80.00
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