HomeMy WebLinkAboutPermit Electrical 1997-11-25SPFllNutjtELO
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Service Included:
ELECTRICAL PERHIT APPLICATION
225 TIFTE STREET
siuucrru,D, oREGoN 97477
INSPECIUON REQT EST z 726-
OFPICE: 726-3759 3. COHPI^ETE FEE SCEEDTILE BELOV
A. Nev Residential-Singlg.or
iiJiri-i"riIY Per dvelling unit'
b Nunber3769
1. LOCATION OF INSTAILATIONrt'\
LEGAI DESCRIPTION
Residenc
JOB DESCRIPTION
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Alaru
Permits are non-transferable and expire
ii ,ort< is not started vi thin LBO days
;i ;;;;";"" o.: if vork is susPended ror
180 daYs.
2. CONTRACTOR INSTALLATTON ONLY
Electrical Contractor-ADT Security'
B
Address
Ci ty Phone 342-1:tq
l-000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home' or
Modular 'DvelIing
Service or Feeder
Services or Feeders
installation, Alterations
or Relocation:
200 amPs or less
201 amPs to 400 amPs
-
401 amPs to 600 amPs _-
601 amPs to 1000 gmPs-
Over 1000 amPs/volts
-
Reconnect OnIY
I tems Cos t
s 8s.00
s r.s.00
s 40.00
$20. 00
1 .00
A n
$ 40.00
$ ss.00
$ 80.00
see ttBtt above
s 3s.00
$ 2.00
Sum
e
$ s0.00
s 60.00
s100.00
$130.00
$300.00
$ 40.00Supervisor License Number 9 49 ,E
Expiration Date
Constr Contr . Number 59944
Expiration Date 4l )7 lqA
Signature of SuPe rvising EIec trlclan
200 amps"or less
;oi ;;; io +oo amPs
-0ver 401 to 600 amps
Over 600 amPs or 1000 volts
Branch Circuits
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D
Ovners Name Eu-
Address fr- I I/\)taf,
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit --
-Each installation
Pump or irrigation --Sien/Outline Lighting-
Limited EnergY/Res I
Limited EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
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OVNER INSTALI.,ATION
The installation is being made on
;;;;;y-i-o"n vhich is not intended
ior sa1e, Iease or rent'
0vners Signature:
cir pnone ? Lil oGzct
DATE:-z>-
E.Miscellaneous (Service/feeder not included)
$20--00
$ 40.00
$ 40.00
$ 20.00
s 36.00
NFATiT 'D"Ullt ( nanoq)
5
Temporary Services or Feeders -i#i;ii;iion, ert"ration or Rerocation
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