HomeMy WebLinkAboutPermit Electrical 1993-5-6
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" ~~jp..ova\. \... D R ELECTRICAL PERMIT APPLICATION
97 .77 Zoning~ /?
7n~;.;,~ J'~ _ CitY:Ob Num'ber. '-7 c::.e; 3 77
Authorized Signature_ ~.--eOM1'Lr.TE PEE SCnEDULE DELO\l
LOCATION OP INSTALLATION ),
:2l?S{;:, ~,,, 't...EL-LJ J .' A. New Residen t ial-Single or
Multi-Family per dwelling unit.
Service Included:
225 FIFTH STREET
S 1'IUNGFI ELI>, OREGON
INSPgCTION REQUI~ST:
OFFICE: 726-3759
1.
LEGAL DESCRIPTION
~T? N/d/LE ~~k
Items Cost Sum
1000 sq.ft. or less L--- $ 85.00 $S
Each additional 500
sq. ft or portion 2- 38
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
Jon DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
100 day~.
Services or Feeders,
Installation, Alterations or
Relocation:
2. CON1~CTOR INSTALI~TION ONLY D.
Elect rieal Con trac tor B " } /S E,)~-J-LI L
Ao(l1:ess l~l [0 lD~ S-t l \ -t Y)
Ci ty ? U~{J , Phone 3~1.0' ~S3
Supervisor License Number 2.08L)G
Expiration Date Jo-l - qS
Constr Contr. Number:::>):SS 1
Y-J-qL(
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
C.
$ 40.00
$ 55.00
$ 80.00
volts see "D" above
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Expiration Date
Signature of ~per~v'sing Electrician
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'--- ~\ v.. _./
, t::Y' - '--'" ~'y'"
O~ners Name~17 I l' ~ ~
.
Dranch Circuits
D.
New, Alteration or Extension Per Panel
Address
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
City Phone
$ 2.00
O\lNER INSTALLATION
E. Miscellaneous (Service/feeder not included)
-Each installation
P~mp or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $,20.00
Limit~d Energy/Com~ , $36.00
The installation is being made on
property I own which is not intended
[or sale, lease or rent.
O..,ners Signature:
)/5
c;. 7r
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5. SUDTOTAL OP,ADOVE
5% State Surcharge
TOTAl.
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RECEIPT #: ~~ J
HECETVED BY: ' - - ,
. . __ .._ . . '". ,_. - .___.. '"0- _ ....'______________
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