HomeMy WebLinkAboutPermit Electrical 1991-08-27:;r.r rrllc;l:IEL()
1
BI^BCTRICAL PBRHIT APPLI(
0A1!
city Job Nuru"t-Q [-l{
225 FITTB STRBEf,
SPRTNGFTELD, ORBGoN 97477
INSPECf,ION REQI'IESTz 726-3769
oFFICE: 726-3759
0r
Expiration Date 3,\3 q2-
s ure of Supervising Electrician
0vners Name
Address
Ci ty Phone
OTINER
The installation is being made on
property I own vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
RECEI {t.n.
Permits are non-transferable and expire
lf r.rork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACf,OR INSTALI,ATION OM,Y
Electri Con t cto
Addr
ci one
Constr Contr. Number Io
Supervisor License Ndmber 33Q\oS
Expiration Date \o\q
3. COHPLBTB I'BB SCEEDULB BELOU
Nev Residential-Single or
MuIti-FamiIy Per dvelllng uni
Service Included:
I tems
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Hanuf'd Home or
Hodular Dvelling
Service or Feeder
B Services or Feeders
Installation, Alterations or
location:
200 amps or less
-l_201 amps to 400 amPs
-
401 amps to 600 amPs
-
601 amps to 1000 amps-
Over 1000 amps/volts
-
Reconnect Only
Temporary Services or Peeder
Installation, Alteration or
D
200 amps or less
201 amps to 400 amPs
-
0ver 401 to 600 amps _
Over 600 amps or 1000 volts
Branch Circuits€rfru-New, Alteration or Extensio
one circui t
Each Additional
Circuit or vith Service
or Feeder Permi t
E. Hiscellaneous (Service/feec
-Each installation
Pump or irrigation
Sign/0utIine Ligh ting_
. Limited Energy/Res
Limi ted Energy/Comm
5. SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
A
$J
(
c
ON
RECEIVED BY:
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