HomeMy WebLinkAboutPermit Electrical 2002-06-26^i{rys"
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BLECT r' -$L PER}/trf APPLICATION
city lobNnmb et O Z-O Aa 67 -O I
3. COMPLETE FEE SCHEDULE BELOW
A New Residential-Single or
Mrilti-Famity per dwelling rmit
Service Included:LEGALDESCRIPTION 1_17Q33€p-a . oa secf
)IJ
Home or
Service
B. Services or Feeders
Installation, Alteratioru or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 ,mtrts
601 ,tnps to 1000 amps
Ovcr 1000 arnpsfoolts
Reconnect Only
5. SUBTOTAL OF ABO\IE
TYoState Surcharge
8% Administmtive Fee
Iters Cost Sum
$106.00
$ 19.00
$ 50.00 _
JOB
Permits are non-transferable
if work is not started within
of issuance or if work is suspendedifetr
180 days.
Signature
2. CONTRACTOR INSTALLATION ONLY
Electrical fl
prcrc4(tl.Sb-l &
Supemisor License Number A5-R6r
Expiration
constr co,l,..Nrruwr b 5 lLl Q
C. Temporary Services or
Installation,
Expiration Date
Signature of Supervising Electrician
SOwners
ZZ'One Circuit
l0
INSTALLATION
The installation is being made on
Fopefiy I own which is not intended
for sale, lease or rent
Each Additional Circuit orwith Service
or Feeder Peririt. ,' : - ' $ 3.00
-E. Miscellaneous (Seryic$eeder oot inchrded)
-Eachinstallation . '
Pump or.irrigatign $50.00
-
SieilOurliselighting $so.o0
Limited Eaergy/Res $25.00
-
Limikdererllcomm Z-$4s.oo +5 oo
Minimum Electric Perrnit Inspection Fee is $45.00 * Surcharges
$ 63.00 _
$ 75.00 _
$r2s.00 _
$163.00
$375.00
s s0.00
$
$s0.00
s69.00
$100.00
volts see
or Extension Per Panel
_ $43.00 _
45.00
200
201
^ s753
I
TOTAL 51.'rs
225 FFTI{ STREET
lpnrNcrmr-o, oBEGoN 9?4??
rNipecuoN REQUEST: 126'31 69
OFFICE: 726'3159
' 'x6T"Bg
fhe
Owners Signatrc:
c,vEla-u*
thereof
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