HomeMy WebLinkAboutPermit Electrical 1998-8-20
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225 FIFTH STREET THIS PERMIT SHALL EXPTmr,r 'HI: W~v"'R:ISAL PERMIT APPLICATION
~~~~~i~~iEg~~~~ 9~i~~J~~IZED UNDER THIS PERMIT IS ~'\:y Job Number q~ /02]-
OFFICE: 726-3759 COMMENCED OR IS ABANDONED FOR
ANY 1~9 gAY pI'!RI~~. 3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION . " .
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LEGAL DESCRIPTION
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JOB DESCRIPTION )., 117~ f
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Permits are non-transferable and expire
if work is Dot started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor /f.tJtf.6' c ?eC-
,
Address 55"// /V'l.AJ /V
City <(,o/,c Phone 7,AC b?clJ
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Supervisor LiceDse Number JI>;l-.J f
/d /'/76'
Expiration Date
It ems
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service IDcluded:
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
5. SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
InstallatioD, Alteration or Relocation
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
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
$ 40.00
$ 55,00
$ 80.00
volts see "B" above
.'
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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. Signature of Supervising Electrician
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- -....." ... D, Branch Circui ts
Owners Name ^TTI"NTlnN:OreaOn law requires you to
follOW rules adopted by the oregon Utility New, Altera t ion or ExteDsion Per PaDel
U::llicatiQp ron'''' Those rules are set forth .. /
. O~~r~~2~Ol_0010thrOUghOAR952-o01-0ne CHCUlt $ 35.00 Jfl70
City In_~ MIllI:.~;n...n";i.."oftherulesbYEa?h A~dition'.'l .
Jw '1' center. (Note: the telephone CHCUlt or Wlt~ SerVlce
O\INER INST~theOregonUtilityNotiflcation or Feeder Perffilt Y $ 2.00 ~.c70
The ins talla t iOD is Gl'l!1~~S~a~~0'~ff2-2344). E. Miscellaneous (Service/ feeder not included)
property I own which is DOt intended -Each installatioD
for sale, lease or rent. Pump or irrigation.
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
CODstr Contr. Number 2" ]j{;)-..c,
ExpiratioD Date
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Address
Owners Signature:
DATE~--------------~-/'~~1-~~---------
RECEIPT II: () J/' 'f..)~ .
RECEIVED BY: tUI W~
9'/'170
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