HomeMy WebLinkAboutPermit Electrical 1996-10-30tt-\o 1u
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225 FIFTB STREET
ipnrNcrrrI,D, oREGoN 97477 ' : -' ":1'
INSPECTI0N REQUESTz 726-3769
OFFICE: 726-3759
1.TION OT INSTALI.,ATION
SPFlIi|GFIELO
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ELECTRICAL PERUIT APPLICATION
Ci ty Job Number 7ot z/7 g
3. COMPT.ETE FEE SCBEDTIIJ BELOV
A. Nev Residential-Single or
MuIti-FamilY Per dvelling unit'
Servi.ce Included:
Items Cos t
$ 8s.001000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home' or
Modular Dvelling
Service or Feeder s 40.00
ot roquire sP
'Zo?;tr1't L-'DL
rA
LOCA
Gto I -*
LEGAL
JOB
Permits are non-trans
if vork is not started
of issuance or if vork
o
rable and exPire
vithin 180 daYs
is suspended for
Sum
ON
$ 1s.00
180 days.
2. CONIRACTOR INSTALLATION ONLY
Electrical Contractor
Services or Feeders
Ins tallation, Alterations
or Relocation:
200 amps or less I
201 amps to 400 amPs
-
401 amps to 600 amps
-
601 amps to l'000 amPs-
0ver 1000 amPs/vo1ts
-
Reconnect 0n1Y
SUBTOTAL OF ABOVE
5% State Surcharge
32 Admini.s trative Fee
TOTAL
B
)A
hone 3LJ3 - /6?l
50.00 -1rte..E..+
60.00
130.00
300.00
40.00
$
s
$
$
$
s
Address
Ci ty
Supe rv i License Number s
Expiration Date /^q1
Constr Contr. Nu
Expi ra t ion Da te-,
mber 5.\P A U? C-<
of SuPervising Electrician
Ovners Name
ss /302/o/h4Q L-ttL/Y7
<Pe-ri,one )f6-Acl6D
Temporary Services or Feeders
;;;i;Ii;iion, Alteration or Relocation
200 amps''or less $ i9'99;oi ;;; io aoo amPs
-
i ::'99o;;.-45i io 600 amis -.- $ so.:99
over 600 amps or fbOO-vTfEs see rrBrr above
Branch Circui ts ' .'
Nev, Alteration or Extension Per Panel
one circuit s 35'oo
Each Additional
Circuit or vith Service
or Feeder P"ro,it"=' L $ 2'oo cA=
Misce]laneous (Service/feeder not included)
9-r q -oo
c
D.
E
Addre
Ci ty
OIINER INSTALI.,ATION
The installation is being made on
piop"tty I ovn vhich is not intended
ior-sale, lease or rent'
0vners Signature:
-Each installation
Pump or irrigation
-
sieh/outline Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
$ 40.00
$ 40.00
$ 20.00
$ 36.00
DATE:
L)RBCEIVED B
oz
5
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aj
Signa
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