HomeMy WebLinkAboutPermit Electrical 1993-09-09225 FIETE STRBEf,
SPRINGFTEI,D, OREGON 97477
INSPECUON REQUEST z 726-3769
CFFICE: 726-3759
1.LOCATION OF
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PERfiTT APPLTCATION
City J Number 4=Jd?
COHPIJTE FEE
e
BELOV
I-Single or// 75 /ilaha A
Permits are non-transferable and expireif vork is not started vithin 180 days
of issuance or if vork is suspended for
i80 days.
2. COMRACTOR INSTALI.ATION ONLY
Electrical Contractor
HuIti-Family per dvelling unit.
Service Included:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
s 85.00
$ 1s.00
s 40.00
Services or Feeders
Insta1lation, Alterations or
Relocation:
IJGAL DESCRIPTION
2n
JOB DESC?.IPTTON
=/a // geeurf{* Sus/..".,,-
s s0.00
s 60.00
$100.00
s130.00
s300.00
s 40.00
36.oc
Sum
?/ dD
B
Address
Ci ty -a- Phone t <-4/r{
Supervisor License Ndmber 5 7 P€ T
Expiration Date ,t4 - 73
Constr Contr. Number 7a-/o7 //5
Expiration Date 6-2F-2A
Signature of Supervising Electrician
200 amps or less
201 amps to 400 "rps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/voIts
Reconneet 0nIy
Ovners Name
Address-
Ci ty
/l/,t/-/
C. Temporary Services or FeedersInstallation, Alteration or Relocation
D. Branch Circui ts
E
200 amps or less g 40.00
201 amps to 400 amps
-
S 55.00
over 401 to 600 amps
-
$ g0.oo
Over 600 amps or 1000 voITs see "8" aEiE
OITNER INSTALI.ATION
The installation is being made onproperty f own vhich is not intendedfor sale, lease or rent.
Ovners Signature:
DATE:
RECE
Nev, Alteration or Extension per panel
One Circuit S 35.00Each Addi t ional
Circr.rit or vith Serviceor Feeder permit _ S 2.00 _
Hiscellaneous (Service/feeder not included)-Each installation
Pump or irrigation
.sign/outl ine Ligh t ing-
Limi ted Energy/Res --
Limi ted Energy/Comm /
SUBTOTAL OF ABOYE
5Z State Surcharge
TOTAL
/, 9'O
)
one
s 40.00
s 40.00
s 20.00
s 36.00
5>
RECEIVED BY:
o 2 270
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