HomeMy WebLinkAboutPermit Electrical 1999-7-13 (2)
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Authorlzad Slgnatura ~f/Jj ATTEIilJON:Oregon la .
U TO!'ow rUles ado ted w requires you to
225 FIFTH STREET .NOliflcation Cent~ Th by the Oregon Ut~hfCTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97!r1filAR952-001 00' Ose rules are set fOrlh \ '~". '
INSPECTION REQUEST: 72@9G.7'68umaY~btl0throughOAR952_I3Mr Job Numbe " 7'6-1-2-/4
OFFICE: 726-3759 calling the cent aln cOPIes of the rV'~~.b '
number for th er. (Note3't)et~R.'Pfibfl~E'}FEE SCHEDULE BELOV
1. ~~ OF I!i~TALLATIONCent ~ Oregon Utility Notific '
"q io IJ N ~I::~ (- errs 1-800.33;p.234ij~v ~~?!J.dential-Single or
Multi-Family per dvelling unit.
LEGAL DESCRIPTION Service Included:
1703:;.700 (/(/103 Items Cost Sum
.f0~
JOB lsr;RIPTION _,' . _. . ' ,_ _ 1000 sq. ft. or less
ftJsm f ('J,{((lh[11 FO/lt.. ~77!'c:Gf' UChrach addi nonal. 500
, sq. ft or portlon
Permits are non-transferable and expire thereof
if vork is not started vithin 180 days Each Manuf'd Home, or
of issuance. or if vork is suspended for Modular 'Dvelling
180 days. . Service or Feeder
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
I ~ h ,Installation, Alterations
Electrical Contractor [,...f(. fJ,/l-b '11m ])ve., or Relocation:
,
Address {pg tuE5r "0" ~ 200 amps or less
5p& / / ,r; 201 amps to 400 amps
Ci ty' INGF/ri:LD Phone 7'17'1.H3(J 401 amps to 600 amps
601 amps to 1000 amps
Supervisor License Number / 'f 73 S Over 1000 amps/vol ts
'0' //11/"1 Reconnect Only
Ey.pi ra t ion Da te II (1/ C/
Constr Contro Number 0%619
!2//i I ()O
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration 'or Relocation
Expiration Date
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Signature of Supervising Electrician
y~, ~.J~U-.-
- ./
Ovner~ Name m.6:s ,r .
Address tql tll/mL llvE4/ltur
Ci ty [:t1Ql3I11G' Phone fcJ9, 220
, Cf 7 WJ t.j. C:r/f.E(;,
OIINER INSTALLATION $,hefhtS h/1,tqh-
The installation is being made on E.
property I ovn vhich is not intended
for sale, lease or rent.
D.
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80.00
see liB" above'
.'
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
(
$ 35.00 35'.
$
2.00,
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
Owners Signature:
------~-------f--r.---------------------
DATE: S/J/q~ '
RECEIPT #: ' . ,fl1 U jj~}
RECEIVED BY: Iff' {.oJ 11""'1
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
, '
.... .
40.00
40.00
20.00
36.00
$
$
$
$
,3S.-
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1.0 C;
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