HomeMy WebLinkAboutPermit Electrical 1991-08-23S1'IIIN(;FIELfD /o t;)
225 FIFTE STRBEf,
SPRINGFTBLD, ORBGON 97477
inspscTroN REQUBST: 726-3769
0FFICE: 726-3759
1. LOCATION OP INSTALI,ATION
*t is*k-
JOB DBSCRIPTION
2. COIITRACToR INSTALI^ATION ONLY
Electrical Contractor
Address
a-
Expira tion Date
Constr Contr' nunbex -?-o - I ? bL
Expiration Date 3
Signa of SuPerv isi ng Blectrician
Ovner s Name I
3. COHPIJTB PBE SCEBDUI.E BELOS
A. Nerv Residential-Single or
llufai-f"*ilY Per dvelling unit'
BIJCTRICAL PER}iIT APPLICATION
CitY Job Number
Service Included:
J.
%
1000 sq.ft. or less
sach additional 500
sq. ft or Portion
thereo f
Each l{anuf 'd Home or
Modular Dvelling
Service or Feeder
Services or Feeders
inst"ff"tion, Alterations or
Relocation:
Permits are non-transferable and expire
if vork is not started vithin 180 days
;; i;;;";"" o, ii vork is susPended for
180 daYs.
Items
/
/
Cos t
s 8s.00
$ 15.00
$ 40.00
$1
$3
$
Sum
P4*
60.oo
B.
Supervisor License Ntimber -7o RS
200 amPs or less
;oi ;;; io aoo amPs
-401 amPs to 600 amPs
601 amps to looo amPs-
over fbOO amPs/volts
Reconneet 0n1Y
one Circuit
Each Additional"iit"ui, or vith Service
or Feeder Permit
$ s0.00
s 60.00
$100.00
30.00
00.00
40.00
C. TemPorarY Services or-Feeders
rnstallationl' iiittttion or Relocation
2oo amps or less ( S 4o'oo /O'*
over 600 t*nl'I"'66oGTt" see rtBrr above
D. Branch Circuits
Nev, Alteration or Extension Per Pane}
$ 3s.oo
Address
Ci tY
DATE:
€,.c + t 'tot phone Llt Gltt a
$ 2.00
OIINER INSTALI,ATION
The instaLlation is being made'on
oroperty I ovn 't'-i"t'-i" iot intended
iot'."rl, lease or rent'
Ovners Signature:
l,liscellaneous (Service/feeder not in
-Each i.:,.11i:l:: g 4o.oo
llll,3:.i!i']1i*:iine- i lt:gt
Limi ted EnergYl.n=r o "6. OO
cluded )
E
5 STIBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
BRECEIVED
4*l: -q.?5
b
I^EGAt*r't
)qq T A /,,;