HomeMy WebLinkAboutPermit Electrical 1996-03-26225 FTFTE STREET
SPRINGFIEIJ, OREGON 97 477
INSPECTION REQTIEST Z 726_3]
oFPICE: 726-3759
5T'TTINGFIELD
and
ELE TRICAL PERHIT APPLICATION
ty Job Nunbe '%a/1'
3. COHPIJTE FEE SCffiDULE BELOV
A. Nev Residential-Single or
Multi-FamilY Per dvelling unit'
Service Included:Items Cost Sum
$ 8s.00
The lollowing prqect as eubmltted has
iljl,"-d, ti".iaieinot require spac:fic lr
,rf&
val.
Zoning,
6gA,uthorlz€d
Signatu re
1. LOCATION OF INSTAII,ATION 7//go
LEGAI DESCRIPTION
JOB DESCRIPTION Zla'+Ar:'7'zc/5
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI,ATION ONLY
Electrical Cont ractor ,.C /,/.-{ Fz"Fz-
Address z2ar,7
Ci ty L o Phone 7e-e ["o/
Supervisor License Number Jo>"J'S
Expiration Date 7O ,/ 26
Constr Contr. Number 7 z -i'r6-
Expiration Date
z>/
Signature of Supervising Electrician
?_
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
B
C
D.
200 amps or 1
201 amps to 4
401 amps to 6
601 amps to l-
00 amps
000 amps_
$ 1s.00
$ 40.00
$ 3s.00
$ 2.00
$ s0.00
s 60.00
$100. 00
s130. 00
$300.00s 40.00
amps
ess
00
a,
Ci ty
OVNER INSTALLATION
The instal,lation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
0vners Signature:
DATE:
Phone ,/ / 2- ogJd
Over 1000 amps/voIts
Reconnect 0nIY
One Circuit
Each Addi. tional
Circuit or vith Service
or Feeder Permit
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAI
Temporary Services or Feeders
Insiallation, Alteration or Relocation
200 amps"or l-ess S 40'00
0ver 600 amps or 1000-voITs see trB. above
Branch Circui ts
Nev, Alteration or Extension Per PanelOwners Name
Address
E. Miscellaneous (Service/feeder not included)
-Each instaflation
Pump or irrLgation
-
Sign/0utline Lighting_
Limited Energy/Res
Limited EnergY/Comm
3la a
$ 40.00
s 40.00
$ 20.00
s 36.00
RECEIVED tu
5 r.79'
---'oT--i ?f.)