HomeMy WebLinkAboutPermit Electrical 1991-06-19onEGorv
1
Permlts are non-transferable and expirelf vork ls not started wlthln 180 daysof lssuance or if vork ls suspended for
180 days.
2. CONIRACTOR INSTALIATION ONLY
ctrlcal Contractor
Add
ct
Supervlsor Li
Explration Date
Constr Contr.r
Explrat Date
of Supervlslng Electr
Ovners Name
Address
SPTIINGFIELO
BLBCTRICAL PBRHIT APPLICATION'[,ti;.,3.
,';:
c{ty Job Number
3. COHPI,RIE trEE SCBEDUIJ BELOS
idential-Single orlly per dvelllng unlt.
Service Included:
Items Cost
1500 sq.ft. or less
Each additlonal 500
sQ. ft or portlon
thereof
Each Manufrd Home or
-Modular Dvelllng
Servlce or Feeder
$ 85.00
$ 1s.00
$ 35.00
B. Servlces or Feeders (10 Branch Circuits
included). Installatlon, Alteratlons
or Relocatlon:
225 PIPTE $MBBT
SPRINGTIBLD, OREGON
IIISPECTION RBOTIEST:
OPFICE: 726-3759
7
,t.'r
100 amps or less
101 amps to 400 amps --iIZ
401 amps to 600 amps
601 amps to 1000 amps
over 1000 amps/volts
-Reconnect Only
200 amps or less
201 amps to 400 amps
-over 401 to 600 amps
-0ver 600 amps or 1000TrIs
Sum
see trBtr affi-
$
$
$
$130
OOTD
$ 35.00
$ 40.00
$ go.oo
00
00
00
00
00
00
35.
60.
90.
$300
$35
c Temporary Servlces or Feeders
Installation, Alteratlon or Relocatlon
crtySD,0..\ Ct Phone
orno\ffi*on
The installatlon is belng.made onproperty I oyn vhlch ls not intendedfor sale, Iease or rent.
0vners Slgnature:
DATE:
D. Branch Clrcults
New, Alteratlon or Extenslon Per Panel
One Circuit
Two to ten Clrcults
Each Addt,I ten orportlon thereof
00
$ 1s.00
Miscellaneous (Servlce/feeder not lncluded)
-Each lnstallation
Pump or irrigation $ 36.00
Sign/outline Lighting- $ 36.00
Slgnal Circuit or
Iimited energy panel_ $ 36.00
00
35
50
$
$
B.
5. SUBTOTAL OF ABOVB
5Z State Surcharge
TOTAL
Phone
e
RECBIVED
oo
Permit No:
Address:
lssued Date t
OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicantsyLo a.re not registered with the Construction Contractors Bbard to'dign thefollowing statement before the building permit can be issued. Licensed Ardhitect
and Enginegl.aRRlicants, exempt from registration under oRS 201.010(7), neednot submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 28
1.-E=a I own, reside in, or wirt reside in the completed structure
2. A. l-l My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work onthe structure must be registered with the Construction Contractors Board.
OR
B.E-I will be my own gen€,ral contractor.
8J,13{p,:tiSiri!1?l".3,l Hu[::fiTXf.'f""ffi],",fif,lsE,"l'3s3.r","8%[H",1":contractor, I will contract with a contrattor'who is regisleieO wlin'ineuonstruction Gontractors Boqrd and I will immediately-notifv the oitiCeissuing this buitding permit of the name ot tne contiiitcii. "
l.hereby certify that the above information is correct and that I have read and understandthe lnformation N.oti-ce to Property Owners about Construction Responsibilities on thereverse side of this form.
nature pp cant
CONSTRUCTION CONTRACTORS BOARD
0244J 1t90
COPY TO ISSUING AGENCY PERMIT FI LEICOPY TO APPLIGANT
@:
I
\r, ltqlql
Date
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