HomeMy WebLinkAboutPermit Electrical 1993-03-16225 FIFTE STRBET
SPRINGFTELD, OREGON 97477
726-376e q
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L PERHTT
Ci ty Job Nunber
200 amps or less I
20L amps to 400 amps _401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0nly
Ai!
APPLICATIONqffiSsl
INSPBCTION REQTIBST:
OFPICE: 726-3759
1
ON
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. COIII"ACTOR INSTALI,ATION ONLY
Electrical Contra to
Addres
Ci ty Phone
Supervisor Ntimbe
H'ftrry-T-itlt$t4D
3. COUPLBTB I'EE SCTTEDULB BBLOV
A. Nev Residential-Single or
MuIti-Family per dwelling unit.
Service fncluded:
Items Cost
$ 85.00
$ 15.00
$ 40.00
B. Serviees or Feeders
fnstallation, Alterations or
Relocation:
Sum
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
s
Expiration p"t. /O I 'qS
Constr Contr. Number
Expiration Date
Signature of clan
0wners Name
Addiess
Ci ty Phone
OIINER INSTALI,ATION
The instaLlation is being made on
property I ovn which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less S 40.00
0ver 40L to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see t'B'r above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
C
E
One Ci rcui t
Each Additional
Circuit or vith Service
or Feeder Permi t
Miscellaneous ( Serviee/feeder
-Each installation
Prrmp or irrigation $Sign/0utline Lighting- S
Limi ted Energy/Res S
Limi ted Energy/Comm $
SUBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
s 3s.00
$ 2.oo
not included )
40.00
40.00
20.00
36.00
5
RECEIVED I}Y
UJ
L000 sq.ft. or }ess
Each additional 500
sq. ft or portion
t hereo f
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder
,oc