HomeMy WebLinkAboutPermit Electrical 1995-03-01/
OREGONCITY OF
The lollowing proiect as
zcning, and does not require speci{ic larrd
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EI,ECTRTCAL PERUIT APPLICATIONapproval'vnA{225 FTITfl STREET
SPRINGFIELD ,OREGON 97477
INSPECTION PGOIJEST z 726-3
OFFICE: 726-3759
1. LOCATION OP INSTATLATION
LEGAL DESCRIPTION
JOB DESCRIPTION
Owners Signature:
v
DATE:
A. Nev Residential-Sing1e or
Multi-FamilY Per dvelling unit'
Service Included:Items Cost
1000 sq. f t. or less $ 85 ' 00
Each additional 500
BELOg
sq. ft or Portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs
--401- amps to 600 amPS
-
60L amps to L000 amps-
Over 1000 amPs/vo1ts
-
Reconnect 0n1Y
-Each installation
Pump or irrigation
Sien/Outline Lightitg-
Limited EnergY/Res
-
Limited EnergY/Comm #
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrati-ve Fee
TOTAL
z6
Sum
tt
Permits are non-transferable and expire
ii ,c,.t is not started vithin 180 days
;; i;;;"."" ot if vork is susPended for
1-80 days.
2. COMRACTOR INSTALI.,ATION ONLY
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
ior sale , l-ease or ren t '
Elec t ricaf Contractor
Ci Phone
Supervisor License Nurn ber {oz3 S
Exp iration Date -t-95
Constr Contr. Number
Expiration Date /u,/A
Signature of Supervising Electrician
Ovners Name LA,,;I /o,,".^l AT ?a t (et,
Address A frr:,3
City E rMF/trj t\PhoneZZ-4JlD
TemporarY Services or Feeders
i;;;;ii.iion, Alteration or Reloeation
200 amps or less,oi ;;; to 4oo amps
-Over 401- to 600 amps
-
Over 600 amPs or 1000 volt
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit I g 35.00 35re
Each Additional
Circuit or vith Service-
or Feeder Pe'*it"-- E $ 2'oo /@@
Miscellaneous (Service/feeder not included)
B
c
D
E
$ 1s.00
s 40.00
$ so.oo
$ 60.00
$100. 0o
$130.00
$300. 00
$ 40.00
40.00
55.00
80.00
s see trBrt aEove
00
00
00
00
$
$
$
$
$
$
$
40.
20.
40
@
5
RECEIVED
36
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