HomeMy WebLinkAboutPermit Electrical 1993-03-12I-!.I
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225 FIFTE STRBET
SPRINGFIELD, OREGoN 97477
INSPECTION REQITBSTt 726-3769
OFPICE: 726-3759
DESCRTPTION
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Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRA TOR INSTALI..ATION ONLY
Electrical Contrac,or rd-
Address
ci ty-Phone
Supervisor License Number
Expiration Date
constr contr. Number
Expiration Date
of ctrician
PERHIT APPI.ICATION
C
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manufrd Home or
Modular DveIling
Service or Feeder
Services or Feeders
Insta1lation, Alterations or
Relocation:
ir*. BLESTRICAL
,:o(*4s
1. LOCATION OF ALIiTION Jreu 3. CoHPI^ETE rEE SCTEDULE BELOV
A+
City Job Number
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
I tems
IJGAL DESCRIPTIONt1oL3L oo ooio Cos t
$ 8s.00
$ 1s.00
$ 40.00
$ s0.00
$ 60.00
$100.00
$130.00
s300.00
$ 40.00
Sum
B
()
Owners Name
Address t+ + + 0 4? cd :tr
Ci ty Phone 14 G-17-t1
OVNER INSTALI,ATION
The installation is being made on
property I own which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
0ver 600 amps or 1000 voTts see rrgrr "[f,!!-
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit L/ $ 35.00
Each Additional
Circui t or vi th Service
or Feeder Permit $ 2.00
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
Sign/Outline Lighting- $
Limi ted Energy/Res $
Limited Energy/Comm $
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/volts
Reconneet 0nly
STETOTAL OP ABOVE
5Z State Surcharge
TOTAL
C Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $
201 amps to 400 amps
-
$
over 401 to 600 amps
-
$
40.00
55.00
80.00
40.00
40.00
20. 00
36.00
5
RECEIVED BY:
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