HomeMy WebLinkAboutPermit Electrical 1994-01-19;::rcrnr ,a a
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225 FIFTE STREE:r
SPRTNGFTBI;D, ORBGoN 97
INSPBCIION RBQIIESI: 7
OFPICE: 726-3759
ELECTRI CAL PEru{TT APPLICATION
477
26-3769 ftco 5?
LOCATION OT INSTALI.ATION
t t tto S he. I I ev -5,] ree-t
Ci ty Job Nuurber
3. COHPIJTB FEE SCMDULE BELOV
ev Residential-Single or
HuIti-FamiIy per dvelling unit.
Serviee Ineluded:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Hodular Dvelling
Service or Feeder
s Bs.oo
s 1s.00
s 40.00
Services or Feeders
fnstallation, Alterations or
Relocation:
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JOB DESCRIPTION
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Permits are non-transferable and expireif vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI.ATION O}ILY
Electrical Contractor
Address PO. &o J/a()g
ciV-E aeytL phone q6/- d(rftr'J
Supervisor License Ndmber /7i9 JLe
Expiration Date /d- /- 7L
Constr Contr. Number
Expiration Dar-e A /ZXtkA
Signatqfe of Supervising EI tri cian
Ovners Name
Address Satn7_
city_yhone 7Jb -7{Z/
OVNER INSTALI-ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECEIPT
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less S 40.00
Over 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see "8" above
D. Branch Circuits
Nev, Alteration or Extension Per Panel
s 3s.00
B
200 amps or less
201 amps to 400 arps
-401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/voIts
Reconnect 0nIy
One Ci rcui t
Each Addi t ional
Circui t or vi th Service
or Feeder Permit
Miscellaneotrs (Service/feede
-Each installation
Ptrmp or irrigation
Sign/outline Lighting-
Limited Energy/Res
SUBTOTAL OF ABOYE
5f State Surcharge
TOTAL
Sum
s 60.00
s100.00
s130.00
$300.00
$ 40.00
s 2.00
r not included)
$ 40.00
s 40.00
s 20.00
S 36.00 3L,CA
50
0050s
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5
RECEIVED BY
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