HomeMy WebLinkAboutPermit Electrical 1992-11-19
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:;;~O~o.l. ~(\ () J ELECTRICAL PERMIT APPLICATION
97/,77 J !\L/ -=' IA
726-3769 20"1" 'iii- City Job Number -/ 'J () II;;)
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r\&tCl SllInll\\Ilf p"PI "",0 rEg. ~cllEDULE nELOII
1. LOCATION 01' INSTALLATION All\hQ
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225 l'IFTII ~TREI,T
Sl'lUtlGFIELll, OIlEGON
INSPECTION REQUI~ST:
OFPICE: 726-3759
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LEGAL DESCRIPTION
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Jon DESCRIPTION L.1"",f,.J 12M1!/
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Permit5 arc non-transferable and expire
if work is not started within 100 days
of issuance or if work is suspended for
100 days.
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Supervisor License N~mber
Expiration Date
Constr Contr. Number
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Expiration Date
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Signature~~i~cian
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Ol/ners Nam '50 f/I, r~~ -f(V'~~" I
Address ,"-r3,f (cJ/Ao-..1A-{ "-CI<J 5~
Ci Iy /7J.J,(CM,. of.. rhone 5'9rfi 7 '1)
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01lNFJ\ INSTALLATION
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The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
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RECEIPT ft: !c'il~'7..
!O,:CETVEIl ny: ,~
Nev Residential-Single or
Multi-Family per dwelling
Service Included:
uni to
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd lIome or
Modular Dvelling
Service or Feeder $ 40.00
$ 50.00
$ 60.00
$100,00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201- amps
Over 401
Over 600
or less
to /.00 amps
to 600 amps
amps or 1000
2. CONTRACTOR INSTAL1.ATION ONI.Y n. Services or Feeders
Installation, Alterations or
Eleetr.ical Contractordt'OI17Jl 0i1A/lAi///l{(ifr(/1Il Relocation:
1 7/Jfru.j
Address PC) tof'~ 131 200 amps or less
( 201 amps to 400 amps
Ci ty 7(.1,(~ m'L.l'hone 3709378 401 amps to 600 amps
601 amps to,lOOO amps
Over 1000 amps/volts
Reconnect Only
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Nev, Alteration or Extension Per Panel
One Ci.rcuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder. not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $,20.00
Limi tell Energy/Comm $ 36.00 'Zk,()C!
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5. SUDTOTAL OPAnOVE ~b,O()
5% S'ta te Surcharge \ . 51 /)
TOTAL "::l.", 9()
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225 FIFTH STRlmT Thel0110WlngprOjectBSsUbmll\ed.ryes~~fCAL PERHIT APPLICATION
SI'IUNGFIELll, OREGON 97/,77 zoning. and does not req~e)eClfIC 1 , n n
INSPECTION REaUl~ST: 726_37l'~proval. ~\L/ City Job Number - \'~ 0'1,1...
OFPICE: 77.6-3759 \Zoninq ((I" .
Date \\ ~'0 ""\ I-01\:OHPLETE PEE SCnEDULE nELOI/
1. ~~ON ml..,INSrALLATIG\l
I \1 Il ) ~ V'( \ n \ [ll I j'\uthorizedSignature. w J\esloentlal-Single or
Hulti-Family per dwelling unit.
Service Included:
200 amps or less
~ 201 amps to 400 amps
, Si.(lnature of Electrician Over 401 to 600 amps
I,! ~ Over 600 amps or 1000 volts
'j X ~ I-~ 7\ l "^ ~On, '. LJ1 "'11, ~,,{]nranch Circuits
;i ::::::sN~n~:3 QJ~/(~JJhQ-ILU~. Alteration or Extension Per Panel
)1 City~QoJQC1 Phone~~&clJg,S ~:~hc~~~~~~onal $ 35.00
'.::;,,' Circui t or wi th serviCt:fle
, OI/NFJl INSTALLATION or Feeder Permi t c-!),~ $,
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E. Hisc~llaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited, Energy/Comm' $'36.00
5. SUBTOTAL OF AnoVE c!) ~ 00
5% State Surcharge \,".l,Q1 <ji'l
(lfIS ~O~~s Nd/ /I-/CUI/)t..~W) ~()
o _~oo_o /3IeAiJ{!)f(!J<TS. H:JK-(pMiUFfW AICCR t:>,c /(rrr!#G~
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non- t l'ans f
if work is not started
of issuance or if work
100 days.
able and expire
within 100 days
is suspended for
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2. COtn'RACTOR INSTALI..ATION ONLY ll.
Electrical contractor~.L,fj ort~~----<.
Addresslli() 0\0J\.mi'ilfttruu
Ci t~D-1 0 fD - Phone 3vA-f/?<:lg
Supervisor License Number ~\~~
Expiration Date t1'J. \ . C14
Constr Contr. Number P)~~OA
Expiration Date \ 8. .14. q'J...
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The installation is being made on
property I own which is not intended
(or sale, lease or rent.
Owners Sicnatllrc:
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DATE: .' , I \ - I -q
RECEIPT ft: . . J I jp ;A
HITElVr:1l IlY:~ 0" .
Items
Cost
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manu!' d lIome or
Hodular Dwelling
Service or Feeder
$ B5.00
$ 15.00
$ 1,0.00
Services or Feeders
Installation, Alterations or
Relocation:
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$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
1:..1{ )
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
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
$
$
$
see "DtI
40.00
55.00
BO.OO
above
2.00 .:JiB