HomeMy WebLinkAboutPermit Electrical 1993-07-08CITY OF OFEGO'V
225 TIFIE STRBBT
SPRINGPIBLD, oREGoN
INSPECTION REOTIBST:
OPPICE: 726-3759
974
Authorized
1. LOCATION OP INST
IJGAL DESCRIPTION
f*=7*7*2, ?29a
JOB
Permits are non-transferable and expire
if vork is not started vithin L80 days
of lssuance or if vork ls suspended for
180 days.
2. CONTRACTOR INSTALI,ATION ONLY
Electrical Contractor
Address
ci Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Exoiration Date
Slgnature of Supervlsing Blectrician
Address
Ci ty Phone '71 ^
OTINBR INSTALI,ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Signature:
DATB:
SPlrT,{GFIELO
as submltled h6
require specific
BLECTRICAL PERHIT APPLICATION
City Job Nunber
BBLOg
Nev Residentlal-Single or
MuIti-FamiIy per dvelling unit.
Service Included:Items Cost
The {ollowing projecl
zoning, end does not
approval.
?L:1
A
B
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dwelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
s 8s.00
$ 1s.00
$ 40.00
t/z
--
&O200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reeonnect 0nly
s s0.00
$ 60.00
s100. 00
$130.00
$300. 00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 4bt to 600 ambs
-
$ 80.00
0ver 600 amps or tbOO voTIs see rrBrr aEoE
Branch Circuits
Nev, Alteration or Extension Per Panel
c
D
'One Ci rcui t $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
B. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/0utIine Light ing_
Limi ted Energy/Res
Limi ted Energy/Comm
SUBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
$ 40.00
s 40.00
s 20.00
$ 36.00
RBCEIVED
=
5
owners w"^" hftf f 172+6
1
2
Permit No:a=zeae
Address
lssued Date:
OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
under ORS 701.0'10(7), need not submit this statement. This statement will be
filed with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
I own, reside in, or will reside in the completed structure.
I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.l--- ---l My general contractor is
Contractor registration numbe
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3.B I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. lf I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the office issuing this building permit of the name of
the contractor.
I hereby certify that the above information is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse of this form.
7^ B-^ ?3
Qnature o rm pp cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
t
WHITE @PY TO ISSUING AGENCY PERMIT FILE
PINK @PY TO APPUCANT
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