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HomeMy WebLinkAboutPermit Electrical 1996-01-05CITY OF 5r f{GFIELD Ij,-,fll"#'J if;-.ii$ ffi ffip",r,. 225 FIFTB STRXET SPRINGFTELD, oREGoN 97477 TNSPECTToN REQ[ EST - rru4f,ggortzod OFPICE: 726-3759 1 TTON OF TTl JOB DESCRIPTION@m4 KAhB+T|K -U{6oW fllFtP4 2. CONTRACTOR INSTATLATTON ONLY Electrical Contractor ee Address ?, O, 8ox ( kE ciry (YXT3€- q1\7 Phone 4t -rocq supervisor License Number 4Ot t\ -9 Constr contr. Number l AZ LO u80 L Date \J.b ELECTRICAL PERHIT APPLICATION City Job Number flum>(e ON 3 A FEE SCMDULE BELOV Nev Residential-Single orMulti-Family per dvelling unit.Service fncluded: I tems Cos t 1000 sq.ft. or less Each addi tional 500sq. ft or portion thereo f Each Manuf'd Home. or -Modular Dvelling Sertice or Feeder s 8s.00 s 1s.00 s 40.00 S Services or FeedersInstallation, Alterationsor Relocation: 200 amps or less I201 amps to 400 amps - 401 amps to 600 amps -601 amps to L000 amps-over l-000 amps/volts -Reconnect Only Sum Permits are non-transferable and expire i f vork is no t s tarted vi thin 180 daysof issuance or if vork is suspended for 180 days. B. s s0.00 s 60.00 $L00.00 s130. 00 s300.00 $ 40.00 @_ Expiration Date Signature of ing Electrician 0vners Name U \C eZ\ r.-lJ r L-9or.J Address 23*U !;i"t t Ci ty Phone OVNER INSTALLATION The installation is being made on property I ovn vhi.ch is not intended for sale, lease or rent. 0vners Signature: DATE: C. Temporary Services or FeedersInstallation, Alteration or Relocation 200 amps''or less S 40.00 201 amps to 400 arp" - S 55.00 over 401 to 600 amps - $ 80.00 Over 600 amps or 1000 voTts see "B", a66iE- D. Branch Circui ts Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Additional Circuit or vith Serviceor Feeder Permi t l0 $ 2.00 @:_ E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0u tline Lighting- Limi ted Energy/Res -Limi ted Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAI _\ s 40.00 s 40.00 $ 20.00 s 36.00 5 RECETVED c Expiration o.t. iO -t- 9€ 1a qfuuf