HomeMy WebLinkAboutPermit Electrical 1998-08-26ai;proval,
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225 FIFTE STREBT
SPRTNGFTELD, oREGON 974
INSPECTION REQUESTz 726-3769
OFFICE: 726-3759
1. LOCATION OP INSTALLATION
sPtl .FIELD
epwilte
llid
land
tlw
A8*
fallowne
ELE TRICAL PERHTT APPLICATION
Job Ntunbe, ?{ tO 7 t
3. COHPI,ETE PEE SCEEDULE BELOII
A to
s 60.00
zoring,aN dooa nd rsqutra
SiQnAure
RD ]U e tsf
Permi ts are non-transferable and exPi
if vork is not started vithin 180 daYs
of issuanc e or if work is susPended for
180 days
2. COT.ITRACTOR INSTATLATION ONLY
Electrical Contractor
Address F
Ci ty Phone
Supervi s or License Number
ANY 1 ?,{.i DAY
Expiration Date
constr contr . Nunaet 7 ?'/ 5 3
Exp iration Date 7-?u
Signa of SuPervis ing Electri an
Owners Name D 'l,at
Address
ci ty-pt,one Lgtk- )9tt
fol
rules are set forth
in OAR 952-001 -001 0 through OARSII-OOI .Cos t Sum
8s.00
15.00
Each Manuf'd Home' or
Modular Dvelling
$ 40.00Sertice or Feeder
B.Services or Feeders
+"L- or Reloc
Installation, Alterations
/ $ so.oo
=
T+i6B
I,EGALno)Lt
DE PTION
f i_
amps
o 1000 amps
amps/volts
Only
100.00
130.00
$300.00s 40.00
s 2.00
$
$
C. TemPorarY Services or Feeders
initaff-aiion, Alteration or Relocat
200 amps"or less $ 4q'gg
201 amps to 400 amPs
-
$ 55'oq
over 401 to 600 ami's --l $ 80109
Over 600 amps or fbOO-voTIs see "B"
D. Branch Circuits
10n
a6ove-
OL l.-Nev, Alteration or Extension Per Panel
$ 3s.00One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
-
OIJNER INSTALLATION
The installation is being made.on
DroDerty I ovn vitiit' is not intended
ioi't"rl, rease or rent'
0vners Signature:
E Miscellaneous (Service/feeder not included)
-Each installation
PumP or irrigation -.-
iin'"u ou trine Li ght ing.--
t iilited EnergY/.Res .--
i:.*it"a EnergY/comm
SUBTOTAL OF ABOVE
i% st"t" Surcharge'g? id-i;tstrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
{2,t'tt
5
DATE:
RECEIVED
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