HomeMy WebLinkAboutPermit Electrical 1998-12-2
c~ ATTENTION:Oregon law requires you to _
~~___._o~~rules adopted by the Oregon. Utility ,
225 FIFTH STREET . ~otification Center. Those rules are setJ!~~TRICAL PERMIT APPLICATION..
SPRINGFIELD OREGON 97lrzQAR952-001-0010throughOAR952-001- non rv,
INSPECTION REQUEST:" 72g~~?~~i.J may obtain copies of the rul~~~ Job Number '""\ 7\ \.~
OFFICE: 726-3759 calling the center. (Note: the telephone .
. number for the Oregon Ulility ~omiwB1ml FEE SCHEDULE BELOV
1. LOCATION OF INSTALLATIAt! Center is 1-800-332-2344). , . ,
l ~-, \ f? ('" f'\C'\ 0 ~\. . A. New Resldentlal-Swgle or
- - - .. . Mul ti-Family per dwelling uni t.
LEGAL p~SCRIPTION . Service Included:
~O?-'3~rL"&('f\~ Items Cost
't>'
II it' f! \
-
,-- --.;,,~. ~ ~ubmitted.~as the
Zoninp J\
Datel:)~
Authorized Signature
c:JOB DESCRIP.TION ~ 1000 sq.ft. or less
o <;: ~.JLti0\qy-o.- \'6\0\ . )Each addi tional, 500
I sq. ft or portIon
Permits ~re non-transferable and expire . thereof
if work is not started within 180 days -Each Manuf'd Home or
of issuance or if work is suspended for . Modu~arDwelling
180 days.' . SerVlce or Feeder
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ED HftJ'-K
Address 3'3'0 CAvY1t' tC(@e..l( (!...0
.B. Services or Feeders
Installation, Alterations
or Relocation:
Ci ty S/'fo
Phone 72lD. -, 0 '-i '0
200 amps or less
201 amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnec t Only.,
Supervi.sor License Number 3577 - S
Expiration Date /0-1-01
Constr Contr. Number.- 2. 0 -.L.f 18' C.
Sum
I $ 85.00
~ $ 15.00
.$ 40.00
<0
3J
$ 50.00
$ 60.00.
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date 5'~ J \ -00 200 amps"or less
NOrlCE.201 amps to 400 amps
Signature of Supervising Electrician Uver 401 to 600 amps
~------~---- . c:: /J .J/2.V? n . t THIS PE~~~J:lA~QceftE IffH~QOOORVKOltS
Lc.X .~~ AUTHOR/ZFO' . .. W -
V .....~ _ ['\'" COM D. lrr~~t9fftI/rI~/ff.teMIT IS NOT
Owners Name . ~ \ t lLU.& MENCED OR IS ABANDONED FO .
l(ll J)~ / "f)4-::l. ANY 180 DA~EfY2RI6btera tlon or ~xtenslOn
Address }! 'tU()( N -....J .
~ ^ One Circuit
Ci ty LUQ:~ p~'one 1#.gll.o1 Each Addi tional
Circuit or with Service
OVNER STALLATION or Feeder Permit
The installation is being made on
property I own which is not intended
.for sale, lease or rent.
E.
$ 40.00
$ 55.00
$ 80.00
see "B" above
- -, .-.'---.-
- ~.-.._........:......_..,-_....._-
,.
Per Panel
$ 35.00
$ 2.00
no t included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Owners Signature:
---------------------------------------
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
DATE:
RECEIPT :j\::
RECEIVED BY:
I,. i . 'i ~ /?
O~ z 2~/
dw
to . ~ .
$
$
$
$
W5ro
5.ICS
,:> .L\:-~_
Jhl4.~
40.00
40.00
20.00
36.00