HomeMy WebLinkAboutPermit Electrical 1997-10-16ox"b4l+i7
SPRINGFTELD, oREGoN 97 477
INSPECTION REQI ESTz 726-3769
OFFICE: 726-3759
1. LOCATTON OF
IJGAL DESCRTPTION7-t
JOB
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days
2. CONTRACTOR INSTALI-ATTON ONLY
Electrical Contractor
Address
ci Phone 7'll Oq 5 1
Supervisor License Number 3-'1q S
Expiration Date to 2_.
Constr Contr. Number o
Expiration Date
Signa of Electrician
Ovners Name
Address
sPT .iFTELO
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Hodular 'Dvelling'
Sertice or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
one Circuit I
Each Additional
Circuit or vith Service
or Feeder Permit
200 amps or less
2O1 amps to 400 amPs
-
401 amps to.600 amps
-
601 amfs to 1000 amps
Over 1000 amps/voIts
Reconnect Oniy
Temporary Services or Feeders
Installation, Alteration or ReLocation
t1uningIveder
ed
p
ud
-FamiIyce IncI
1
Servi
tMuIs 1
I Cos temst7 Sum
$ 40.00
40.00
55. OO
80.00
ee nBil a566
$ 8s.00
.B
C
00
00
00
00
00
00
s s0.
S 60.
40s
$100
$130
s300
c
200 amps"or less S
201 amis to 400 amps
-
$
over 401 to 6oo amps
-
$
Over 600 amPs or 1000 volts s
D. Branch Circuits
'C trx/i
NLv, Alteration or Extension Per Panel
$ 3s.oo 7ED
Ci ty Phone
OVNER
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
OvnersiL$ignature:
DATE:
$ 2.00
E Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting-
Limited EnergY/Res
Limited energY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
s 40.00
s 40.00
s 20.00
s 36.00
5
RECETVED
_ q1
o'()
a a
Ci ty Job Nunber
COHPI,ETB FEE SCEEDT'I.E BELOV
$ 1s.00
ELECTRICAL PERHIT APPLICATION
IS 5
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