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HomeMy WebLinkAboutPermit Electrical 1990-12-28,C'TY OF OREGO'V lf vork ls not started vlthin 180 daysof lssuance or lf rrork ls suspended for 180 days. 2. CONIRACTOR INSTAI,LTITION ONLI 225 TIFTH SI1BET SPRINGPIBU), oREG0N 97477 INSPBGIION RBQIIBST: 726-3769 OPPICB: 726-3759 1.OP INSTALI.ATION 5 )Fl, 4ue .dQ ?tu>1 a IAGAL DBSCRIPTION-27 JOB DBSCRIPTION 72Perml t non-transferab explre Electrlcal Contractor Address ct ty-Phone Supervisor Llcense Number Explratlon Date Constr Contr. Number Bxplratlon Date ET.BSTRTCAL PBR}IIT APPLICATION clty Job Nunber %Zg#O 3. COHPI,ETB PEB SCIIEDUI.B BBLOS New Residentlal-Single or Multi-Faml1y per dvelllng unlt. Service Included: Items Cost 1500 sq.ft. or less Each addltlonal 500 sq. ft or portion thereof Each Manuf,d Home or -Modular DweIIing Servlce or Feeder $ 8s.00 $ 1s.00 $ 3s.oo D. Servlces or Feeders (10 Branch Circuits included). Installation, Alteratlons or Relocation: SPTIINGFIELt) 100 amps or less 101 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect 0nly Sum a* $300.00 $ 3s.00 $ 35.00 $ 60.00 $ 90.00 $130.00 C. Temporary Services or Feeders Installatlon, Alteratlon or Relocatlon 200 amps or less $ 201 amps to 400 amps - $ Over 401 to 600 amps $ 3s.00 40.00 80.00 Owners Name Address ,q f /,,tFi, 4oo. ctW S ?Fl 0. dl qunphone ')q6 -a33J OITNER INSTALI,/\TION The installatlon ls belng made onproperty I ovn vhlch is not lntendedfor sale, Iease or rent. 0sners Slgnature: DATE: 0ver 600 amps or 1000ErEs see 'B' a56ilE- D. Branch Circults New, Alteratlon or Extenslon Per Panel One Circuit Tvo to ten Clrcults Each Addt'1 ten orportion thereof $ 1s.00 Miscellaneous (Servlce/feeder not lncluded) -Each installation Pump or irrigation $ 36.00 sign/outline Lighting- g 36.00 Slgnal Clrcuit or llmited energy panel $ 36.00 SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL t,tvl 00 00 $ gs. $ s0. E 5 RBCEIVBD BI b*t *'e Slgnature of Supervislng Electrlclan Permit No: Address:C*'-9,,q ,T ( lssued Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Gontractors Board to sign the fo!lowing statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 28: 1.EJ lown, reside in, or will reside in the completed structure 2. A. l-l My general contractor is Gontractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B.I will be my own general contractor. lf I hire subcontractors. ! will hire only subcontractors reoistered with the Construction Contractors Board. lf I chanoe my mind and -do hire a oeneral contractor. I will contract with a contrabtor -who is reoistered w-ith the Constructi'on Contractors Board and I will immediately-notify the office issuing this building permit of the name of the contradtor. I hereby certify that the above information is correct and that I have read and understand the lnlormation Notice to Property Owners about Gonstruction Responsibilities on the reverse side of this form. tjlt*fr lz^v0 Signature of Permit Applicant CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 te WHITE @PY TO ]SSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT @s ?&