HomeMy WebLinkAboutPermit Electrical 1999-07-02{GFII;-LD
Zoning LP TL
ZZ5 FIFTE STREET Dare 1-a-=ELECTRICAL PERUIT APPLICATION
City Job Nunber QProT {
COHPLETE FEE SCHSDULE BELOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
ftems Cost
The following project as submitted has the followinozoning. and does not require specific land use "
approval
SPRINGFIELD' OREGON "9*671"0 Sisnature
INSPECTION REQUESTz 726-3769
oFFICE -. 726-3759
1 LOCATION OF INSTALLATIONu{qo }Y tL
3
A
tft)Y'YWTYb(>co Sum
DESCRIPTION
Permits are non-transferable and expireif vork is not started vithin 1B0 daysof issuance or if ruork is suspended for
180 days.
2. COMRAC-TOR INSTALI,.ATION ONLY
Electrical Contractor s t
Add ress 0 a B,X 2V? 3
pnone b88 -lb/ I
or Relocation:
200 amps or less
20L amps to 400 amps
-
401 amps to 600 amps
--601- amps to 1000 amps-over 1000 amps/vo1ts
-
Reconnect 0n1y
1 Feeders
Ao 08t
B
.00
.00
.00
$ s0.00
s 60.00
s100.00
s130. 00
$300.00
$ 40.00
Reloca t i o
'.00
.00
.00ilB', aE6tE-
8;m
Ci ty
Supervi-sor License Number 3 Y7 7 J
Expiration Date lO-o/-O/
Constr Contr. Number .f,ff
Expiration Dare 1A- 3O -oo
Signature of Supervising Blectrician
0vners Name
Address 3 3
Ci ty (,^acu*fu Phone ? Y2- -3 65L
OVNER TNSTALLATTON
Nev, Alteration or Extension per panel
One Circuit $ 35.00Each AdditionalCircuit or vith Serviceor Feeder permit
--
$ 2.00
Miscel-laneous (Service,/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lighting
Limi ted Energy/Res
Limi ted Energy,/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini.strative Fee
TOTAL
C
D
E
n
b-
200
201
0ver
0ver
Bran
amps t
40L to 600
600 amps or 100
ch Circui ts
The installation is being made onproperty f ovn ruhich is not intendedfor sa1e, lease or rent.
0mers Signature:
$
$
s
$
0040
40.00
20.00
36.00
5
DATE:
R.ECET
RECETVED B
Q-eq -7 P
1000
Each
Utility
Servites or Feed ers ).terati ons