HomeMy WebLinkAboutPermit Electrical 1995-03-29SPRr FTELE'
225 ET.vlg STREET a*8:A-.{-
SPKTNGFIELD OREGON 97 477
INSPECTION REQI]EST:726-3t69ortzsa
OFFICE:7 26-3759
1 LOCATION OF
LEGAL DESCRIPTION
JOB PTION
afi
CitY Jo b Nunber ?AD
3. COI{PI,ETE TEE SCEEDIII'E BELOE
a9
zoans--k7*--=BI,BCTRICAL PERI{IT APPLICATION
'V
A Nev Residential-S
Multi-FamilY Per
Service Included:
200 amPs or
201 amPs to
401 amPs to
60L amps to
ingle or
dvelling
I tems
amDS
amDS
olts _--
unit.
r Cost
$ 8s.00
$ 1s.00
$ 40.00
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
s 40.00
Sum
L000 sq.ft. or fess
nr"t, ..iaitional 500
sq. ft or Portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
installation, Alterations
or Relocation:
2. COMRACTOR INSTATLATION ONLY B
Electricaf Contractor Son i trol Secur i tY
Address P.. Box 21009
City Euqene Phone 46 1 -5678
Supervisor License Number lLr E{?
Expiration Date -q/-
C
Constr Contr Number 65 1 49
Expiration Date 6-28-96
Signature.of ising Electrician
2-
Permits are non-transferable and expire
if vork is not siarted vithin 180 days
of issuance or ri-vork is suspended for
180 daYs '
o I
4
6
1
amps
ess
00
00
000
/10vners Name L
Ci Phone
Temoorary Services or Feeders
irri.if"iir", Alteration or Refocation
200 amps or lesstoi ;;; to 4oo amps
-0ver 401 to 600 amPs ---:Over 600 amPs or 1000 volts
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit $ 35'oo
Each Additional
Circuit or vith Service
or Feeder Permit $ 2'00
Over 1000 amPs/v
Reconnect 0n1Y
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
-t
$
$
$
S
40.00
55.00
80. 00
ee I'Brr aSoF
not included)
40.00
40.00
20.00
36.00 W
OYNER INSTALLATION
The install-ation is being made on
p.op".ty I ovn vhich is not intended
for sale. lease or rent'
Ovners Signature:
Miscelfaneous ( Service/feeder
-Each installation
Pump or irrigation $
SLgnZOutline Lighting-- tt:.ilited Energy/Res
-
S
Limited tner[yZcomm I S
E
5
DATE:--' go
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