HomeMy WebLinkAboutPermit Electrical 1996-05-15225 FTYTH STREBT
SPRTNGFTELD, OREGON 9747
TNSPECTI0N REQIIBST z 726
0FFICE: 726-3759
1. LOCATION OP
Al,7
L.EGAL DESCRIPTION o
JOB DESCRTPTION
nSla /lu T V
Permits are non-transferable and expire
if vork is not started vithin 180 days
,r i.ir""ce or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI,ATTON ONLY
El-ectrical, Contractor Son i trol Secur i ty
Address P.O.Box 21 009
Phone 46 1 - 5678
Supervisor License Number
Expiration Date /D- /-qA
Constr Contr.Number 65 1 49
Expiratio n Date 6-28-96
Signa ture of SuPervis Electrician
0vners Name
Add ress bx /as^
Ci ty 4 pno". ?41- /5i,7 /
SPIiT,\lGFIELE'
EI,ECTRICAL PERHIT APPLICATION
City Job Nunber
SCEEDIIIJ BELOS
Nev Residential-Single or
Multi-Family Per dvelling unit'
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ Bs.oo
$ 40.00
Services or Feeders
fnstallation, Alterations
or Relocation:
I.^r" :"rg,8Itd
apurwal.
Zoni
Authortsf
rrot tPr:'
A.
7S
B
s 1s.00
s s0.00
$ 60.00
$100.00
s130.00
s300. 00
$ 40.00
$ 40.00
s ss. oo
$ 80.00
see ItBrt
s 3s.00
$ 2.00
Sum
a6ove
OVNER INSTALI.,ATION
The installation is being made on
;;;p;;iy r ovn vhich is not intended
for sale, lease or rent'
Orrners Signature:
200 amps or less
201 amps to 400 amPs
-401- amps to 600 amPs
-
601 amps to 1-000 amPs-
Over 1000 amPs/vo1ts
-
Reconnect 0n1Y
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40'00
LiilitedEnergy/Res -
-
S20'00
Limited Energy/comm --- s 36.00 @
3+a_
C
E
TemporarY Services or Feeders
rnsiallaiion, Alteration or Relocation
200 amps or less
201 amps to 400 amPs --
Over 401 to 600 amPs
Over 600 amPS or 1000 voTts
D Branch Circuits
Nev, Alteration or Extension Per Panel
DATE:7-as
RECEIVED
5
?8-86
city Euqene