HomeMy WebLinkAboutPermit Electrical 1997-06-10fl\&
j,,.b/1[41- -225 FT?TH STREET
SPRINGFIELD, OREGON 9747
INSPECTION REQT'EST.. 726
OFPICE: 726-3759
SPRINGFIELtf
200 amps or less
201 anps to 400
401 amps to 600
601 amps to 1000
The lollow
zoninS, ar
approvai,
,#
1
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. CONIRACf,OR INSTALL.ATION ONLY
Electrical Contractor E>Hnu-
LOCATIOU OF INSTAILATTON,l'15 5 L(Lva n
ELECTRICAL PERHIT APPLICATION
COHPTJTE FEE SCffiDtILE BELOV
v Residential-Single or
1ti-Family per dvelling unit.
rvice Included:Items Cost
-37 69 t\,.f-tl1 crryJob Numbe. ?J0b0'1
3
A Ne
Mu
Se
'q
-10 Jg't
Sum
bove
B
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home- or
Hodular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
amps _amps_
s 8s.00
s 1s.00
$ 40.00
s 40.00
$ ss.00
s 80.00
s see (B( a
s 3s.00
s 2.00
Address ?C.fe <
L{L
Ci ty SP+o Phone
c)c s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
!
amps
il_
Supervisor License Number 3s 77- S
Expiration Date o-t-ntr
Constr Contr. Number
Expiration Date (- I ^ 91
Signature of SuPe rv ing Electrician
0vners Name
Address
Ci ty one Ll a
OVNER ON
The installation j.s being made on
property I ovn vhich is not intended
for saIe, lease or rent'
Ovners Signature:
DATE:
Over 1000 amps/vo1ts
Reconnect 0niY
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less
201 amps to 400 amPS
-
Over 401 to 600 amPs
0ver 600 amps or 1000-v=oTT
(
C
D
E
Branch Circuits
Nev, Alteration or Extension Per Panel
i n
One Circui t
Each Addi tional
Circui t or vi th Servica,,
or Feeder Permi t .L ,l
Miscell-aneous ( Service/feeder
-Each installation
Pump or irrigation S
sign/outline Lighti-ng- S
Liilited Energy/Res
-
$
not included)
40.00
40.00
20.00
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative FeeDI]AET
b'
5 Wrfui*
T,EGALt10I DESCRIPTION7t 3'l, ot4
. JOB DESCRTPTIONtt,t"qiiiY'i au ba^,-WA fuqk