HomeMy WebLinkAboutPermit Electrical 1997-01-22CITY OF SPRINGFIELD, OREGO'V
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EIJCTRICAL PBRHIT APPLICATION225 FIYTH STREET
SPRINGFIELD, OREGON 9] 477
INSPECTION REQUBSTz 726-3769
OFFICE: 126-3759
1 ON OF TNSTALI,ATION
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Ci ty Job Number
/l/p9'P I,ETE FEE SCEEDIII,E BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service IncLuded:
I tems Cos t Sum
Permits are non-transferable and expire
if work is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALLATION ONLY
Electrical. Contractor Son i trol Secur i ty
Addre ss P. O. Box 2 1 009
Ci ty Euqene Phone 46 1 - 5678
Supervisor License Number
Expiration Date /o-/-q?
Constr Contr'Number 651 49
Exp iration Date-€-4*'S -7 d
Signature of Su ising Electrician
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Servi.ces or Feeders
Ins tallat ion, A1 terat ions
or ReLocation:
JOB DESCRIPTTON
200 amps or 1
201 amps to 4
401 amps to 6
601 amps to 1
Over 1000 amP
Reconnect Onl-
200 amps or
201 amps to
Over 401 to
Over 600 amp
s 8s.00
s 1s.00
s 40.00
s s0.00
s 60.00
s 100. 00
s130. 00
s300. 00
s 40.00
s 35.00
s 2.00
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B
TemporarY Services or Feeders
Installation, Alteration or ReLocation
e SS
0O amps
00 amps
000 amps_
s/voltsv_
Les s
600 amps
s or 1000 volts
f<
C
D
E
a6ove
s 40.00
s ss.00
s 80.00
see "Btt
Ovners Name Aa /G Branch Circui ts
Nev, Alteration or Extension Per Panel
Address ,Sa lzlrrQ
ci ty _pho "e 74 6 - SGaB
OIINER INSTALLATION
The installation is being made on
property I own vhich is not intended
for sale. Lease or rent'
Owners Signature:
DATE
RECE
One Ci rcui t
Each Addi tional
Circuit or vith Service
or Feeder Permit
Mj.scell-aneous ( Service/feeder
-Each ins tallation
Pump or irrigation S
Sign/Out1ine Lighting- S
t iili ted Energy/Res -- S
Limi ted Energy/Comm I S
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
5
not included )
40.00
40. o0
20.00
36.00 @?
oT)
/Dr
RECEIVED B -F s*-
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