HomeMy WebLinkAboutPermit Electrical 1995-05-18SP}. .iFTELG'
The prcjact
does noi requiro s;.rnir
I f .i
225 FIWE SIB.EET
SPRINGPIEID, oREGoN 97477
INSPEGTION REQIIEST: 72
0FFTCE: 726-3759
1 LOCATTON OF INSTALTATTONb?q du tnct /{
ON
JOB DBSCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CO\ITRACTOR INSTAII.ATION ONLY
Efectrical- Cont ractor SonitrO I Securit v
I
Address P.O.Box 21 009
Ci Eu ene Phone 461 -5678
t,:r,,:,j--fu--D<-* ELEgrRrcaL pERurr AppLrcATroN
9tE-City Job Number 5C SPr-
SCEEDIILE BELOS
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems
A
Supervisor License Number l'-70'-lLE
Expiration Date
Cons tr Contr. Number 65'149
Exp iration Date 6-28-96
Signature of Supervising Electrician
n hA fl4trc-.^;r
Ovners Name
c.Temporary Services or Feeders
fnstallation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000 voTIs
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401, arnps to 600 amPS _
601 amps to 1000 amps-
Over 1000 amps/volts
Reconnect Only
One Circuit
Each Additional
Circuit or vith
or Feeder Permit
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
B
D
Cos t
$ 8s.00
$ 1s.00
$ 40.00
$ 3s.00
$ 2.00
&60
Sum
a66ve-
@
$ s0.00
$ 60.00
$100. 00
$130.00
$300.00s 40.00
$ 40.00
$ ss.00
$ 80.00
see ItBtr
Branch Circuits
Nev, Alteration or Extension Per Pane1
Address
Ci ty
t-*/t1 ?
Phone r' '* -ao4-
OSNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for safe. lease or rent.
Osners Signature:
iiis-.-5>7K>-
Service
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
sign/Outline Lighting- $
Liili ted Energy/Res -7- $
40.00
40.00
20.00
36.00
5
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CITY OF
RECEIVED d/,bo
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