HomeMy WebLinkAboutPermit Electrical 1999-08-06225 FIFTB STREET
SPRINGFIEI', OREGON 97 471
INSPECTION REQIIESTT 726-3769
OFFICE: 726-3159
1 OF TION
I.,EGAL
JOB DESCRIPTION
Permi t s are non-transferable and exPire
if vork is not started vithin 1B0 daYs
e or if vork is susPended for
iirrfrffH"
SHALL EXPIRE IFTHEWORK
E.}PT B. Se
SPRINGFIELt)
I
ELECTRICAL PERHIT APPLICATION
Ci ty Job Nurnber
3. COHPI,ETE FEE SCffiDTILE BELOV
Nev Residential-Single or
MuIti-Famil-Y Per dvelling unit'
Service Included:
I tems Cos t
L000 sq.ft. or less
Each additional 500
$ 8s.00
sq. ft or
Ins t
>-
A
Sum
Ad$Lf,/r rt
Ci ty Phone
Supe rv i *so r License Number 5
Expiration Date /a -/-dil
Constr Contr. Number f),*f/
Expiration Date /o "/- f 7
ing Electrician
200 amps or less F
201 amps to 400 amPS -__-401- amps to 600 amPs
-
601" amps to 1000 amPs--
Over L000 amPs/vo1ts
--
Reconnect 0n1Y
'f,,
$ s0.00
$ 60.00
s100.00
s130.00
$300.00
$ 40.00
$
s
$
$
TemporarY Services or Feeders
inii.fr"iion, Alteration or Relocatio
200 amps''or less I
201 amps to 400 amps
-
Over 401 to 600 amps
-
Over 600 amPs or 1000 volts
Branch Circuits
o Sa
0vners Name s
Address 395 g+4.-
C.
D
n
40.4$ 40.00
$ ss.00
$ B0.oo
Ci ty Phone
Nev, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
s 3s.00
E Miscellaneous (Service/feeder not included)
see 'rBtt aSove
$ 2.00
OVNER ALLATION
The installation is being made on
piop"tty I ovn vhich is not intended
for saIe, lease or rent'
Orners Signature:
-Each installation
Pump or irrigation _-_
Sign/Outline Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
00
00
00
00
40.
40.
20.
36.
0.
5 SUBTOTAL OF ABOVE
5% State Surcharge
3Z Administrative Fee
TOTAI
DATE:
RECEIVED B
61)
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