HomeMy WebLinkAboutPermit Electrical 1992-05-05C'TY OF
225 FIFTE STREET
SPRTNGFTBLD, oREGoN 97477
INSPECTION RBQIIEST. 726-3769
OFFICE: 726-3759
1 LOCATION OF INSTATI,ATION
Job Number
FBE SCEEDULB BELOIT
Nev Residential-Single or
HuIti-FamiIy per dvelling unit.
Service fncluded:
Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or Less
201 amps to 400 amps
-40L amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
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SUBTOTAL OP ABOVE
5I State Surcharge
TOTAL
PERHIT APPLICATION
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4wvd.
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JOB DESCRIPTTON
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuanee or if vork is suspended for
180 days
2. CO.ITRACTOR INSTATI,ATION ONLY
Electricar contractor [}HE$$H EtECTtiC SEP'YIff
dJ Sum
ee ilBl|above
not included)
40.00
40. o0
20. 0o
B
Address QS-)or))D;$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Ci ty
Supe
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Expiration Date '
Constr Contr. Number --)o4 (" C-
Expiration Date
trician
Ovners Name [( t,
200 amps or less $
201 amps to 400 amps
-
$
0ver 401 to 600 amps _ $
0ver 600 amps or 1000 volts s
Miscellaneous (Service/feeder
-Each installation
Pr.rmp or irrigation $
Sign/outline Lighting- $
Limited Energy/Res _ $
Limited Energy/Comm $
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit t $ 35.00 3S3Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
40.00
55.00
80.00
Address
Ci ty Phone
OTINER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
RECEIPT
E
5
RECEIVED BY:
Signa ture of
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