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HomeMy WebLinkAboutPermit Electrical 1994-11-23C'TY OF ORECON 5PR'NGFIELD zii.r ti ,,. -ijiii c$us not requiro specirlc lend ue€ L ,L % 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 '2_.uo {o <Z- +o'----vv-T--7--RECIIIVED I] ^q "q tu