HomeMy WebLinkAboutPermit Electrical 2002-08-26Oct- IA-OI O1 :43P
22J FIFTH STREET
SPRJNOFTELD. ORECON 9?{77
INSPECTION REQUEST: 1 16-3i 6.)
oFFICE.726-17i9
OF
E LEC'TRJ CAL PER,\,,{ I T APPL] CAT ION
Cit.y JobNumber DZ-OlOO6-Ol
3. COIv{PLETE FEE SCFEDULE BELOW
A. Nerv Rcsidcnli;rl-Single or
/ao -zO or less $ I o(,. (,0
hor
_ $ l9.oo
Ea:ir l"larurld llor:rc or
\.{odular Dr',,elIing
Sen ice or Feeder
In.r(nl In1i11n, Altcrations or
Rclocution'
D
City t-Phone
OWNER INSTALLATION
The installaUon is being rrrade on
property I own rvhich is uot intcnded
for srle. lease or rent.
Orvncrs Signature
2{X) anrps or less
2i)l anrps to.l00 amps
i0l lnrps to 6tJtl amps
frill lru,,irs to l0{}0 anrps
Over i0U0 ampVvoits
Reccnnecr Onlv
C. 'femporar.v Scrvices or Fcerlel's
Installation. Altcration or Relocution
200 anrps or less
201 anps to 400
Over 101 to 500
amps \t
sU
Each Additioual
orF
the
\ne
P-O1
_ $iuoo _
__ $ 63.00 _
.- $ 75.00 _-_
-_
$ l25.oo --..-_ $t63.00 .-.
_ s37.r.00 _
$ 50.00
.00
dl/
LEGAL DESCRTPTIOi
-i7er5-?s,f ' 4trHP.'J;:l-"::?H3'H':";[:n#ffif$'ffi'H.,lcrdrrerring'n'],.,,, .",,
yn IIiiSTALLATION
t i+At'J?A
apProval u
C,
Sum
JOB N
(ZL-1 '
2 CONI'RAL'TOR tliSTALl-ATIOl,i ONLY B. Serr.iec.r or Feeders
Pernr i t.c il rc rron -r ntnsferable ary!,1q6gil!ed Signature
if lrork is ll(,t slirncd *,ithin l8U days
ol issttanq: or if n'ork is suspeudcd for
I tl0 dnys.
,Add""rs i6? { 4ort/tLJ\Q
Elccrricul Conrrircrgr Alert f,lectric , Inc.
Address 1970 N..28tl: Street
ci$S rl_n field PYa7,s 7 47.=?213
Srrpen-isor Licensc Nurnber 243-S__
Expiration nrfu . 1-ffi
Constr Contr. Nunber L27 7 2
Explntrion Dr 5-22-
nf Supcn'ising Electrician
rvners Name II j)sr Panei
\he
I1
{. SUBTOTALOFABOVE
l%u Stltr Surcharge
S %o Attrninistr'ative Fce
$ 3.00 1
00--
the $50.00
_- s25.00 _
s45.00
Inspccrion f ec is S{5.00 - Surchitr8c-r
57
I $43.m qS
\s-_
_w_- tttL-
or
r\\
a(e
otto\o\
$J
TOTAL
<sBoJr.-
t/Yl
: L,I
Llr'!-vu
IHU I