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HomeMy WebLinkAboutPermit Electrical 1996-9-13 --rrl " 'l{;~ ,V) ~ . . . \ ' ' ?....:~,.::.~l,\J~~;d~dO~:::.;; ;'K:"{ iequire specl ic Uan ,;,'~'J' ,)\;,,1. V ' , lOnil"rg___L 9~i~~:f76S q - \ 1o-ttV ..v1A AuthOrIzed Signature ' 0 , \ 225 1:.u' ~ n S'!REE'I' SPRINGJ:~LD, OREGON INSPE~~~ON REQUEST: OFFICE: . 726-3759 1.. LO$:A'IION OF INSTAllATION {;~ ~ l A) CE')'\.)"\1c~It\.~h m_ LEGAL DES c;::a;rL' l.~ ON l/(7~ ;2 7l.( 50 5~OD ~~~~~J~~S~~~ Permi ts are non-transferable and expire if va rk is no t star t ed vi thin 180 days of issuance or if vork is suspended for 180 days. ",;.~, ;r' 2. 'CON'I'RAC!OR msrAllA'!ION ONLY Electrical Contr~ctor Phl\;?~ ~~ctnG Address.3 i70 mp,:-~ L.AJ Ci ty tfll ~~ Phone Cc~-(o 12... { . D " Supervisor License~umber q~l~ S lO/q !~ 4Constr Con'tr. Number~- \1<l G _Io/q(p Expiration Date Expira tion Dat~..~ Sign~ ture ,of juPervisi~g E~ectrician C__, c;/ ~ '- O..mers N~~ ri...~.t..\\::; 1\ ~ ~~~~ Address ~q t\l~ wkLl.., Gj S11:f".)..(8 City 6~o Phone i~~2~1!!i:. OYNER INSTALLATION The ins talla tion is being made on property I own vhich is not intended for sale, lease or rent. Ovners Signature: DATE: q -- {/-q D:J RECEIPT I: 2:2.,/K<X RECEIVED B 1: Ih' ELECTRICAL PERHrr A.PPUCATION '- Ci ty J,ob Number q G Cl q L{ 'S 3. CO liP Lr. U~. 1: u:. SCREDtJI..E BELOY' A. Net,.{ Residential-Single ar Multi-Family per d',elling unit. Service Included: Sum Items Cost 1000 sq. ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Borne or Modular Dt,.{elling Service or Feeder B. Services or Feeders Ins talla tion, Alterations or Relocation: 200 amps or less I 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only S 85.0Q S 15.00 S 40.00 LIDO 0 S 50.00 .:]L $ 60.00 $100.00 S130.00 5300.00 S 40.00 C. Temporary Services or' Feeders Installation, Alteration or Relocation 200 amps 201 amps Over 401 Over 600 or less to 400 amps to 600 amps amps or 1000 volts D. Branch Circui ts S 40.00 S 55.00 $ 80.00 see "B" above New ,AI tera tion or Extension Per Panel One Circuit Each Additional Circui t: or wi th Ser'lice or Feeder Permit (p S 35.00 $ 2.00 /2,,0 Miscellaneous (Service! feeder no t included) -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy!Res Limited Ener~J/Comm E. 5. SUBTOTAL OF ABOVE 5Z State Surcharge ~utl TOTAL . 3 ~ i"\-V m w.J Tb~ S 40.00 S 40.00 S 20.00 S 36.00 (" d-~; 5/0 l&"t- ~..,v