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Home My WebLink AboutPermit Electrical 1992-01-07C'TY OF 5a'rrrN(-t-lLLlJ ELECTRICAL PERHTT APPLICATION ab q\\8a4.a4 A B. 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 amps- Over 1000 amps/volts Reconneet 0nly c ity Job Number COHPLETB FEE SCEEDULE BELOV Nev Residential-Sing1e or MuIti-Family per dvelling unit. Service Ineluded: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or -Modular DveIIing Service or Feeder $ 8s.oo s 1s.00 s 40.00 Permits are non-transferable and expireif vork is not started vlthin 180 daysof issuance or if vork ls suspended for 180 days. 2. COMRACTOR INSTALT.ATION ONLY Electrical Contractor Address Ci ty Phone Expiration Date Constr Contr. Number Expi.ration Date Signature of Supervising Electrician Ovners Name Address 1 ON IN I,EGAL Sutt:\ \ry'6'ri{ffit-TJSA $ s0. $ oo. $100. $ 130. 00 00 00 00 s300.00 $ 40.00 Temporary Services or Feeders Installation, Alteration or Relocation 2C0 amps or less S 40.00 Over 401 to 500 amps _ $ 80.00 0ver 600 amps or 1000 volts see rrBrr abo're l-i r Phone INSTALIATION 14tp- The installation is being made on property I ovn vhich is not intendedfor sale, Iease or rent. 0vners Signature: DATE: RECEIPT D. Branch Circuits New, Alteration or Extension Per Pane} One Circui t Each Addi.tional s 3s.00 Circuit or vith Servi or Feeder Permit E. Miscellaneous (Service/feeder not includec -Each installation Pr.rmp or i rri gat i on Sign/outline Lighting- Limited Energy/Res Limi ted Energy/Comm SIETOTAL OP ABOVE 5Z State Surcharge TOTAL wv- ?$ 5 s $ S s 00 00 00 00 40. 40. 20. 36. RECEIVED BY oo Supervisor License Ntimber Y OF SPR,as t1 5t'iltNGFTELr) 225 FITFIE STRBEf, SPRTNGFTELD, OREGON 97477 INSPECf,I0N RBQUBST. 726-3769 OFFICE: 726-3759 1 LOCATT ELECTRICAL PER}IIT APPLICATION Ctty Job Numbex ?/ /G ZL/ 3. COI{PLETE FEE SCMDULE BBLOS A. Nev Residential-Single or MuIti-FamiIy per dvelling unit. Service fncluded:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 Services or Feeders fnstallation, Alterations or Relocation: db 200 amps or less </ 201 amps to 400 amps _401 amps to 600 amps _601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL 5z c/ IJGAL DBSCRIPTION.7a-o4z> JOB DESCRIPTTON4 -*uzza lrf4r-- s,,Z=./'Permits are non-transferable and expireif vorlc is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CONTRACTOR TNSTALI^ATION ONLY Electrical Contractor Address Ci ty Phone Supervisor License Ndmber Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Blectrician Ovners Name Address €i27 *+672',r Ci Phone 2?e s622 OSNER II{STALI.ATTON The installatlon is being made onproperty I own vhich is not intendedfor sale, Iease or rent. Ovners Signature: DATE: C. Temporary Services or FeedersInstallation, Alteration or Relocation Sum B $ $ $ $ $ $ 50.00 60.00 100.00 130.00 300.00 40.00 ,> = 200 amps or less $ 40.00 201 amps to 400 amps - $ 55.00 over 401 to 6oo amps - g go.oo 0ver 600 amps or 1000 'vo[s see rrgrr "ffi D. Branch Circuits llew, Alteratlon or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit g 2.00 l'liscellaneous (Service/f eeder not included )-Each installation Pump or irrigation $ 40.00Sign/outline Liglrting- $ 40.OOLimited Energy/Res -- S 20.ooLimited Energy/Comm $ 36.00 E 5 a42 ?o C- RECBIVED BY: ,+. 2- a 1 2 Permit No: Address: lssued OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. A My general contractor is Contractor registration numbe I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.B I will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certily that the above information is correct and that ! have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this lorm. /z-3o-7 gnature t Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 3 OR WHITE @PY TO ISSUING AGENCY PERMIT FILE PiNK COPY TO APPLICANT a>u rX_-]