HomeMy WebLinkAboutPermit Electrical 1992-8-27
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225 FIFTH STREET ap;:~~' and ~troleCf a. ELECTRICAL P'ERMIT APPLICATION
IELD OREGON 97477 a/., e. not sUb"'ltt Q- Y-
SPRINGF . require s Sd has t fl 2JJ 0 D
INSPECTION REQUEST: 726-3769 ffl" PSCifjClan':F.t>tz~iJt?b Number v{
OFFICE: 726-3759 Oate 6, "s. *
' AtJth~ . ' OI1PLETE FEE SCHEDULE BELOIl
1. LOCATION OF INSTALLATIONlZec: SiGnat .
2,q ~/) ~~ v1I\ V'\ UfO Nev Residential-Single or
() ulti-Family per dvelling uni t. "
LEGAL DESCRIPTION Serv 'ce-l!tcluded:
1 /1) /_ =="X>.o ('") i9 L I 'D \ It ems Cos t Sum
Signature of Supervising Electrician
~' ~~
"'..._,.,,~~
. -u~-/r ~ 'D.
Owners Name V/t1 Jr1JYvJ (7)'1H'hiU'J.- fusi Branch Circui ts
II ({il ( -It) I f Nev teration or Extension Per Panel
Address~ (', J1 Qj_lE::.- C)-r- ~
$ 35.00
Phone
, Circuit or with Servicr,
OVNER INSTALLATION ~/~ or Feeder Permit ~'$ 2.00 ~
The 'installation i1ffi ~ 'IJ/ ' E. Miscellaneous (Service/feeder not included)
property I ovn vhic I~ ntended -Each installation
for sale, lease or ;fit. Pump or irrigation $
j Sign/Outline Lighting $
O\ffiers Signature: Limi ted Energy/Res $
Limited Energy/Comm $
1,~.07)
'=') .;?o
loq .::>.,r,
JOB DESCRIPTION
6iP, fI f\L.e... -\- 'f. {'~tyVwftt7
Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor A,4-s E1 .LJr.>J..
Address "2--1 ( i 0 c J 0 CLV LaJJ~~ P-J
Phone t..fb ( 2-771
Number 3t=177_S
Ci ty E---CAc,...
(/
Supervisor License
Expiration Date / () -I - q 7____
Constr contr, Number f.(> 7_1 ~ 7 c:;
1'2--14 - q 7
Expiration Date
--------~C1-------------~--------------
DATE: 6 -27 -q? "
RECEIPT lI: l:,~,:?;q
RECEIVED BY: (LoAd _
1000 sq,ft, or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85,00
$ 15.00
$ 40.00
B.
Services or Feeders
Installation, Alterations or
Relocation:
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
I
$ 50,00
$ 60,00
$100.00
$130.00
$300,00
$ 40,00
S:?eD
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55,00
$ 80.00
see "Bit
above
volts
40.00
40.00
20.00
36.00
5,
SUBTOTAL OF ABOVE
5% State Surcharge
,,' ,
TOTAL