HomeMy WebLinkAboutPermit Electrical 1997-11-18CITY OF SPR OFEGO'U
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Ci ty Job Nurnber
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,*,flJlg-1,{225 rrFTE srREET r r'i'r:r'' '' :
SPRINGFTELD, OREGON 97477
INSPECTION REQIESTz 726-3769
OFPICE: 726-3759
INSTALI.,ATIONz? r.rl,2-
SHALL
OB IS
AI.IY 180nAY
PER\OD
1. LOCATION OF
/1f .z e 70
JOB DESCRIPTION
1.a ri f fr6ztr-r
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vrork is suspended for
180 days.
3. COHPT,ETE FEE SCEEDULE BELOV
A New Residential-Single or
MuIti-Family per dvelling unit.
Service Included:ftems Cost
L000 sq.ft. or fess
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular DvelIing
Sertice or Feeder
s 8s.00
$ 15.00
Sum
$ 40.00
2. COMRACTOR INSTALLATION ONLY B Services or Feeders
InstaIIation, Alterations
or Relocation:Electrical Contractor 2UZf &Zk
Address 5J/,/ /nz.a./,.,/200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect OnIy
Ci tv f.rl -rZJ4 Phone 2)-. 670/
Supe rvisor License Number ]o>-rJ
ration Date ./z/7 f
trcontr. *ru Temporary Services or Feeders
Installation, Alteration or Relocation
C
Expiration Date -roy'A
00
00
00
00
00
00
60.
100
130
300
40
s
s
s
s
s
$
50
Expi
Cons
200 amps''or les
201 amps to 400
over 40L to 600
Over 600 amps o
ampsr 1000-75ITs
s 40.00
55.00
80.00
ee 'Btr aMve
$
$
$
s
amps
Signature of Supervising Electrician
Z az----' Ar'^-:--=---.-
0vners Name lnz-.Zz-.i*t Z?.azz
rF-
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
one circuit / $ 35.00 )fart
Each Additional
Circuit or vith Service
or Feeder permi t 5 $ 2.00 ,t'4oa
E Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
S 40.00
Liilited Energy/Res -- $ 20.00
SUBTOTAL OF ABOVE /5A O
5Z State Surcharge
Address
Ci ty ;rV Z2'Phone ?Y/ )<7d5
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
3Z Administrative Fee
5
2,2f/J7
RBCEIVED TOTAL *e.fo