HomeMy WebLinkAboutPermit Electrical 1997-09-16SP'l JFIELD
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33i.llll*,.i5f;l.o *'i 6*tL-(J ELECIRTCAL PERHIT APPLICATTON
City Job N,-b", ?7f,8O
3. COHPLETE FEE SCHEDTILE BELOV
INSPECTION REQI.IEST:
OFPICE: 126-3759
1 OF INSTALI.,ATION
I,EGAL DESCRIPTION
JOB
Permits are non-transferable and expire
if work is not started vithin 180 days
of issuance or if vork is suspended for
1B0 days.
2. CONTRACTOR INST
El-ectrical
Address
Ci ty one
S Number
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
L000 sq.ft. or less
Each addi.tional 500
sq. ft or portion
t hereo f
Each Manuf'd Home or
Modular Dvelling
Sertice or Feeder
$ 8s.00
s 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
A
C
D
Sum
ONLY B
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
0vners Name
Address
Ci ty Phone
OIINER TNSTALLATION
Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps or less -'-
201" amps to 400 amps
-401- amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/volts
-Reconnect 0n1y
One Circui t
Each Addi tionalCircuit or vith Serviceor Feeder permit
$ s0.00
s 60.00
s100. 00
$130. 00
$300.00
s 40.00
:;ae
Exp e
200 amps''or less
201 amps to 400 amps
-over 401 to 600 amps
-Over 600 amps or 1000-?ofTs
Branch Circui ts
$
$
s
$r
0040.
55.
The installation is being maproperty f ovn vhich is notfor sale, lease or rent.
Ovners Signature:
Pump or irrigation
Sign/Outline Ligh ting_-Limited Energy/Re
Limited Energy/Comm
00
00
ee rBil aEdG-
s 3s.00
$ 2.00
s 40.00
$ 40.00
$ 20.00
s 36.00
BO
Nev, Alteration or Extension per panel ,
de on
in tended
E Miscel-laneous (Service/feeder not included)-Each install_ation
5 SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini.strative Fee
TOTAL
DATE:
W r
RECETVED B
-c>
/7laz^Z=-n, --O- o
Electrical
Department of Consumer
nuitaing Codes Division
cationP.^'mitAPPli
& Business Services
/
FOR DEPARTMENTUSBONLY
Residential per unit service included:
1,000 sq. ft. or less " " " """"
Each additional 500 sq ft' or portion thereof" """
LimiEd energy
Each manufacturcd home or modulm
dwellingseniceorfeeder" " """ "" """'
Services or feeders: installation' alterations' or relocation
200 amPs or less
201ampsto4O0amps"""" " " """'
401 amps to 600 amps " " """"" "
601 amps to 1,000 amPs
Over 1,000 amps or volts "" "" "" " '
Temporary services or feeders: installation' alteradon or relocatton
,*.*
200 amPs or less
201ampsto400amps " "" .' """
Over 401 amps to 600 amps " "" " '
Over 600 arnps or 1,000 volts see services or feeders section above
Branch circuits: new, alteration or extension per panel
i.- ffr" fo fo, u.unch circuits with purchase of seruice or feeder fee
Eachbranchcircuit" "" """ """ 5200
U. ft "
f." fo, t.*"h circuits without purchase of a service or feeder fee
Each additional inspection over the allowable in any
2
2
2
2
2
2
2
2
2
z
2
4
z
2
$3s.00
Number of insPections Per permit allowed I
$40.00
$40.00
of the above, per impection: -' ' :
Reconnect onlY
$50.00
$60.00
$100.00
$130.00
$300.00
$40.00
$55.00
$80.00
$35.00
$2.00
$85.00
$15.00
$20.00
$40.00
$40.00
Firstbranchcircuit..."" " " " "'
Each additional brmch circuit " " '
Miscellaneous (service or feeder not included):
Each pump or irrigation circle " " '
Each sign or outline lighting
Signal circuit(s) or a limited energy' panel'
alteration, or extension " " """ " "
Items Cost (ea') Sum
Fees collected:
A. Enter total of above fees " """ " '
B. F,nler 47o Surcharge ('04 x total above) " " "" '
C. Enter 17o Surcharge
D. If required (see plan review section)' enter 257o of line A " ""'
for Plm review
Total fees:
<20.00>
Less bulk label fee (if applicable)
Less fe collected: tr Check tr Money order """" " " $ <- >
$
$
$
$
$
Balance due:
I 195
t25l
t76l
t2l?
Job
Address
ZIP:State:City
-rr4
'e-
and expire if work is notand non-refundableare non-transferable suspended for 180 daYsor if work isstarted within 180 days of issuance
County:
C//-
Job no.
2P'3/e<-
1L1
C
Phone
Z(t *,
kdSo*
rt, I
'7
J Ni.
gry,thZIP:CIQ,State:
Electrical contractor:
Contractor's license no':
PropertY owner:
Contractor's board reg' no'
Address LA,\
City:
Date
I own,noton
State @- nv
Owner's name
for sale, lease, or
Address:
City:
The
Owner's
TALLATIONLOCATION OF INS'
CONTRA CTOR INSTALLATI ON
OWNER INSTALLATION
FOR FISCAL USE ONLY -79999810600
22
White - Salem440-2584 (7|96/COM)Pink - Customer Yellow - Field
Permit no.
Label no.
Date issued:
Issued bY:
Office:
FEE SCHEDULE
Signature of
License no.:
REQUIRED)(IFSECTIONT.EVIEWPLAN