HomeMy WebLinkAboutPermit Electrical 1995-07-26O;atr*qCt*C
225 FTYTE SlBEEf,
SPRIICFIBU), oREGol{ 97
zoning, and as submftad has
approval.roquiro specrfic land
c.
B.
BIJSTRICAL PERTTIT APPLICATION
City Job Nunber
EEE SCEEDT'I,E BELOS
Nev, AI teration or Extension Per Pane1
SPflI}IGFIELO
Authorized Signatur
1.OF INSTALI.ATION A.
IJGAL
JOB DESCRTSrION
//1)6ruM
Pernl ts are non-
lf vork is not s
of lssuan ceorl
180 daYs.
2. CONItsACIOR INSTAIJ'ATION ONLY B'
Ele c t r i cal Con t rac t o r Phil ips-flrec'f-Lj-c't- Inc'
Address
INSPECTION RBOIIEST:
OPPICE: 726-3159
Cit! Frrgeno Phone 91402 bb8'012/
Supervisor License Number ^71qs
Nev Resldentlal-Sing1e . or
iiiiti-r"tilY Per dverling unit'
service rncrudedt ,a"rs cost
1000 sq.ft' or-Iess S 85'00
iu"t ".iai tional 5oo-ss. f!.or portion g 15.00
Each Hanuf'd llome or
Services or Feeders
ii"t.ii"tion, Alterations
or Relocation:
HIUiifl ,*:"ii::,ll'li"li'i"1o"" t ion
ifli]ii ;;i',[,'1ffi.*" l"1ail =Over 600 amps ol
Branch Circuits
7
L0/e5
Sum
ffi:ffiI.'Jl':id=|,Hfi
<
ExPiration Date
Constr Contr' Number 20-179C
Expiration Dat
Slgnature of ing Electrician
Ovners
Address
cl Phone
DATE:
OVNER INSTALI'ATION
The lnstallatloir ts beirig made on
Droperty I ovn "ttiitt-f! iot lntended
i;;';;iL' lease or rent
Omers Signature: ',
one Circuit /
Each Additional-Eii"rit or vith service
oi ru"der Permi t
Hiscellaneous (Service/ f eed
-n."tt lnstallation
iii[zottiine-Li ght lns-
liilit"a EnergY/Res
et0
D
f
$ 35.00 3s
$ 2.00
-er not included)
$ 4o.oo
$ 40.00
,$ 20.00
$ 36.00
RBCEIVBD
5.STIBTOTAL oF AlovB ^ = ?€o=o=
#";;;; iu'ct'"r!" 1,2 + rQl--fu
not
g nq
v1
D,a
and exPlre