HomeMy WebLinkAboutPermit Electrical 1997-04-22aC'TY OF
JOB DESCRTPTTONlns/'a/l Sr; u r
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Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATTON ONLY
Electrj.cal- Contractor gon i t ro I Secur it
AddressP.O. Box 21009
Ci ty Eu qene Phone 461 -5678
Supervisor License Number /6m pET
Expiration Date /0-/-7q
Constr Contr. Number 651 49
Expiration Dare 7-2OOO
Signature of Supervising Electrician
SF..r.-iiF|ELD
ELECTRICAL PERHIT APPLICATION
City Job Nun a"91nsK l
FEE SCETEDIIIJ BELOV
v Residential-Single or
lti-Family per dvelling unit.
rvice Included:ftems Cost
1000 sq.ft. or l-ess
Each additionat 500
sq. ft or portion
thereof
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
$ 40.00
Services or Feedersfnstallation, Al-terationsor Relocation:
rl
225 FIFTr STREET
SPRINGFIELD, OREGON 97 4]7
INSPECTI0N REQIIEST: 126
OFFICE: 726-3759
q
Au'ihorlzo<l Si gnature
1. LOCATION OF INSTAILATION
/4+h//7 NeA
Mu
Se
Sum
B
v
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
-601 amps to 1000 amps-
Over 1000 amps/volts
-Reconnect 0n1y
s s0.00
s 60.00
s 100. 00
s130.00
s300. 00
s 40.00
C Temporary Services or Feedersfnstallation, Alteration or Relocation
200 amps or Less $ 40.00201 amps to 400 amps
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S 55.00over 401 to 600 amps
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$ 8O.OOOver 600 amps or 1000-7;ITs see uBu aEilE-7
Ovners Name rh,Gnt/
Address 4OOO
Ci ty Phone
OIINER INSTALLATION
The installation is being made onproperty I ovn vhich is not intendedfor sale. lease or rent.
Orrners Signature:
DATE:
RECE
D. Branch Cireuits
New, Alteration or Extension per panel
One Circuit S 35.00Each Addi tional
Ci rcui t or r.ri th Servi ceor Feeder permit S 2.OO
E. MiscelLaneous (Service/feeder not included )-Each installation
lymp or irrigation gSign/Out1ine Lighting- $Limi ted Energy/Re SLimi ted Energy/Comm --f- S
40. 00
40. 00
20. 00
36.00
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTALRECEIVED
5 0b
%M
no oroiecl as subm'lte
O-dbes not roquire sPe
LOnirl
49s-l4n4
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