HomeMy WebLinkAboutPermit Electrical 1998-04-0224a-o( ??(*o t | ,o - "8
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SPRINGFIELD
PERHIT APPLICATION
b Nunber QK O S 7)2
"scmpu.r BELog
I-Single orr dvelling unit.
Items Cost Sum
s 8s.00
s 1s.00
$ 40.00
$ s0.00
$ 60.00
s100.00
$130.00
s300.00s 40.00
approval.
225 ETYTE STREET
SPRINGPTEI^D, OREGON 97477, :
INSPECf,f0N REQI BSTz 7.26+.37
OFPICE: 726-3759
Authorizod Signature_
1. LOCATION OF INSTALI.ATIONt3b t{}n)A
LEGAL DESCRTPTTON
JOB DESCRTPTTON
Mu
Se
1000 ft.
Each itA'l arm Tnsta 1 1 et aon
sq.
add
2. CONTRACf,OR TNSTALI^ATTON ONLY
Electrical ContractorADT Securitv Svstems
Address 1501 pearl St et. Suite B
Ci ty Eusene.OR Phone 54t-342-13I3
Supervisor License Number 793 tr
Expiration Date 10/01/96
Constr Contr. Nrrb"r 59944
Signature of Supervising cl.an
Ovners Nane AC,/qF *u €./.-.'*
Address / 7 6, ,1)^, f^? 2^o/
citvSZDo-C, (/ phone 7"/^ 2a0o7"7=---7-
OIINER TNSTALI,ATTON
The installation is being made onproperty f ovn vhich is not intendedfor sale, lease or rent.
Osners Signature:
DATE:
sq. ft or po
thereof
Each Manuf'd ,
Hodular 'DveIling
Service or Feeder
Services or FeedersInstallation, Alterations
or Relocation:
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
B
c
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps-
Over 1000 amps/vo1ts
-Reconnect 0n1y
Temporary Services or FeedersInstallation, Alteration or Relocation
D. Branch Circuits
200 amps or less S 40.00
201 amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
$ 80.00
0ver 600 amps or 1000 voTEs see uB' aEffi
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 3s.00
$ 2.oo
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lighting-
Limi ted Energy/Res
-Limited Energy/Comm I
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAI,
36.00
s 40.00
s 40.00
$ 20.00
$ 36.00
I .80
1 .08
RECETVED
- 1-.d (5
38. 88
15.00
Expiration Date 04I 29 /97
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