Loading...
HomeMy WebLinkAboutPermit Electrical 1992-9-21 rT, hE Yfinnm' l'L'":'I t1~ . :\ "~:,r:' 9rld Q(JQSfrmt _4 ~;~~~~:~~~GON 9774276~:7"6;h9; '~'I,1T~'ruv INSPECTION REQUEST: l,':\,'....1 LA OFFICE: 726-3759 - -t..J I AUlh:r~Zod ~ignatureJ ~ 3. COMPLETE FEE SCHEDULE DELOIl 1. LOCATION OF INSTALLATION ~ 7'9 S-R ./71';1fJt 6>-=- LEGAL DESCRIPTION /7~2-3'.e":;>O .4J'3Y~~ , , JOB DESCRIPTIOli-- ~ ~;i'/4(-::' ~~ /~~-:~. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY (;i ty Job Number 9'2/':2/d A. . "'~'''-'....J New Residential-Single or Multi-Family per dwelling Service Included: uni t. Items Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modulai Dwelling Service or Feeder Cost $ 85.00 $ 15.00 $ 40.00 B. Services' or Feeders Installation, Alterations or Relocation: Electrical Contractor Address City Phone Supervisor License Number Expiration Date 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 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 s~ . ()() Constr Contr. Number C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date Signature of Supervising Electrician Owners Nanie~.AtA1' ~/C l!=~ Address ~ CitY~~~,,-Phone??L n~ '/ ," OVNER INSTALLATION The 'installation is being made on property I own which is not intended for sale, lease or rent. ovnLt;;rrre~cJ) ~ ------t-----------------~-~-t=;r------ DATE: f);,ly.q~ ' RECEIPT #: /p';::;:;:3 I RECEIVED BY: /II,iJ Ilkv--'- 200 amps or less 201 amps to 400 amps Over 401 to 600,amps Over 600, amps or 1000 D. Branch Circuits $ 40.00 $ 55.00 $ 80.00 volts see "~" above New, Alteration or Extension Per Panel One Circuit Each Addi tional Circuit or with Service~ or Feeder Permit --i:) $ Miscellaneous (Service/ff.fder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. ~ $ 35.00 ~' '"" 2.00 ~--' J!)-' lfD not included) $ 40.00 $ 40,00 $ 20.00 $ 36.00 ~~ &Z-.i0 ,._"":!f' 'J IV ~ f/Jf:<-"lP:) ';;:,/0 ...... -1- M -t-cvt t &_15- I D~ 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL