HomeMy WebLinkAboutPermit Electrical 2002-05-08SPRINGFIELD. ORECON 97+77
INSPECTION REQUEST: 7 26-3'/ 69
OFFICE: 726-3759
I. LOCATION OF INSTAILATION
! l(,O *'72&
ELEC.,iJCA-,,ERMIT APPLI CATION
Citl'Job Numt,e,'C? -C'' O liZ 7-Cl
3. COMPLETE FEE SCHEDULE BELOW
A. Nen' Residential-Single or
Multi-Family per drvelling unit.
Service Included:
Items Cost
has ft. or less $ 106.00
additional 500
$ r 9.00
tl 1,/d Horne or
rvelling
Service or Feeder
B. Serlices or Feeders
Inst:rllirtion, Altcrations or
Rclocltion:
200 anrps or less
201 arrrps to -100 arnps
-101 amps to 600 anlps
(l0 1 lrrnps to l0{)0 antps
Oi'er 1000 amps/r'olts
125.00
s375.00
Reconnect Only 50.00
S
225 FIFTH STREET
'"fYo"e'fH'io* o't Lo t Sum
JOB DESCRIPTION
€,*,*.-l' Uil
Permits are rlon
if lvork is not started lv
ofissuance or ifrvork is suspended
180 dai's.
2. CONTRACTOR INST
&rt.
not
$ 5o.oo _
Electrical contrn.tf @ "5fr^,
r-
$ 63.00
_ $ 75.00 _
63.00
-
$+i.(){) -
or u ith Scrv'icc
$ 3.00 _
'ccder not included)
Expi rarion Dare @</tso /a v.- -- T--- 1 .
Signature of Srqtcnising Electriciitn NY'1 amps
Ovcr 600 amps or 1000 r,olts see
"B" abolc
D. Branch Circuits
Nor Alteriltiou or Extension Per Panel
One Circuit
U amps
h
E.
(-)
orvne rs N"*" U ,'c k '\ C -t (
Attttress I ( b(? 7) ', LkL
Srgt J,Phone
OWNER INSTALLATION
The installation is being made on
prope rty I orvn u'hich is not intended
for sale. lease or rent.
;lone
itication _ $5o.oo _an _ $50.00 _
$25.00
N'[inimum Electric Permit Inspection Fee is S]5.00 * Surcharges
->c)
Limited Energv/Cornm
J. SUBTOTALOFABOVE
7%o Stile Surchtrge
8%o Atlministratil'e Fce
_ $-15 o0 _
Js.)
qoo
97
Oryners Signlture:
TOTAL
9a
ZG
Cin' w4+t*<*.2,'lh Phonc 7 t/Y-O?oS-
3AQG:S
Srrpcrr isor Licerrsc Nurnber TA* Zct i C
Expiration Date l0/zo /o4
r0B
$5o.oo _
$69.00 _
$i00.00
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