HomeMy WebLinkAboutPermit Electrical 1996-2-14
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SPRI_':ELD
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225 FIFTH STREET Thefo\loW!~gd~~,~I~~t~qUire spec~UW1'R!tAL PERMIT APPLICATION C
i~~~i~:fREg~~~~ 9~~~~3769 ~~;~,,;,~n . ., rij)(U Ci ty Job Number OlloJ) ~ :~
OFFICS: 726-3759 ZonH'\~L -- " --
f~/(t.f3k.-B::OMP E FEE SCHEDULE BELOY
1. ~ IsOCkTION O'fl:, I~f~MtION r?a~_ '
\,~~ 0 \ \10' \\ 0' ,\1\ \r1 ~rlzedSignaw~a 1\eSldential~Single or
, - - - - " ' Multi-Family per dvelling unit.
Service Included:
/ f}B~(;jffION (tW)
IAII MOB 'DESCRII7IO~' -\--
L] ~'1 )\ ~9\~~\~~ .~ \()} ()-~Ul\-.\
permi~a~~~r ~~n~exPire
if york is not started yithin 180 days
of issuance or if york is suspended for
180 days.
!
2. CONTRACTOR INSTALLATION ONLY
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Electrical Contractor BUILDERS
Address
293 MONROE,
Ci ty ElJGENE
Phone 485-0922
Supervisor License Number 2970S
Expiration Date 10/1/95
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Constr Contr. Number 04296'~:'"
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
Exptration'Date
12/10/95
,200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40'.00
S 55.00
$ 80.00
see "D" above
. SIgn~UP~~cian
Owners Nam~ ~(1J l~~)
Address} ~{QJ (I0[};oQOJ~D
City ~/fft Ph on e!J1h rr:f15
OVNERLINSTALLATION
D.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circ~it or vith Service
or Feeder Permi t / $ 2.00 4
The installatioh is beirig made on
property I ovn vhich is not intended
for sale, lease or rent.
OWners Signature:
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigationS 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 0-9.W_
5% State Surc~~rge (~ . ( L!-J
!~ ~VO J ",t.:) 0
0'(Y.Il.p
DATE~------------------~~~~~-~
RECEIPT t: ( n , _ ~'/ J
RECEIvED BY: ~~ \ f\/\. J (
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