HomeMy WebLinkAboutPermit Electrical 2002-02-04225FffTH STREET
1. LOCATION OF 2_-
830 N 21st
tz o S/OO
JOB DESCRIPTION
Add heaters
Permits are non'transferable and expire
if *o.t is not started within 180 days
olir.r*"" or if work is susPended for
180 daYs.
2. CONTRACTOR TNSTALLATION ONLY
Electrical Contractor JB EITECTRIC' INC'
Address 4685 lsabelle Street
ELECTRICALPERMIT 'LICATION
-ol
or
Multi-FamilY Per dwelling unit.
Included:Cost Sum
$106.00 $ -
Items
1000 sq. ft.. or less
Each additional500
sq. ft or Portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$19.00 $ -
$s0.00 $ -
B. Services or Feeders
Installation, Alterations or
Relocation:
ior urt p, to.4QQ3SpI.,,, g.,r, . Ji?v-,sq;,, *fl:.33 ++
:3iffiilflste?H1*lggpg=
over fi{H eBg{S{tfu 01 0 throug,trOAFigSi{ro,eo f _
cailing the cente-r.^(Note: thetelephone ,
c. TempordigBedD6opttB6t6bon Ufl tity Notiiication
Cenre r I s 1 -Brl0-3gp-i044).
City Euqene. QR 97402 Phone .5
Supervisor License Number 38 72.S
Expiration Date 1
ccB
Expiration Date 1 t02 3t1
Electrician
Name
Sheyl Dixon
Address -1291
G
City SPrinqfield' OR 97477 Phone 579-3199 cell
The installation is being made on
properly I own which is not intended
for sale, lease or rent.
Owners Signature:
200 amPs or less
201 amPs to 400 amPs
Over 401 to 600 amPs
Over 600 amPS or 1000 volts see
B above
NOTICE:
D. Branch
New,
One
Each Affiig6gf
or Feeder
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
S igrr/Outline Lighting --
Limited Enerry/Res
Limited Energy/Comm
5. SUBTOTALOFABOVE rrxmur
7o/o State Surcharge
8% Administrative Fee
$4500 $
$
$
$s0.00 $ '
1
1
ConsfiConfi.Number 37587C 104929
$
$ 43.00
ls3 .00 $ 3.00
$s0.00 $
$s0.00 $
$25.00
$45.00
46.00
3.22
3.68
$
$
JB #_u TOTAL $s2.90
7c)
IFTHEWORK
UNDEBTHIS PEqMlT