HomeMy WebLinkAboutPermit Electrical 1997-05-19SPflINGTIELO
225 FTYTE, STRBET
SPRTNGPIELD oREGoN 97477
INSPBCTTON REQUEST: 726-37
0FPICE: 726-3759
ELECTRICAL PERHIT APPLICATION
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Job Numbe,c/ lo7V7
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1. LOCATION ALI.ATION
PEE SCEBDIILE BELOII
A. Nev Residential-Single or
Hulti-FarliIy per dvelling uni t.
Service Included:
/eq DI OF INST
Lt-Y--
JOB DESCRIPTION
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Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days
2. CONTRACTOR INSTALI"ATION ONLY
Electrical Contrac tor IZUA?*U, ete.Cvt? tC
Address /JO A-l.n^ )nr€-.
Ciry EuaGilE Phone,7V4- 35toi
Supervisor License Number tDg
Expiration Date
Constr Contr. N umber q
Exp iration Date 3
Signature of Supervising Electrician
I tems
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Hodular Dvelling
Servlce or Feeder
Services or Feeders
fnstallation, Alterations
or Relocation:
200 arnps or less I
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amPs_
Over 1000 amps/vol ts
Reconnect 0nly
200 amps or less
201 amps to 400 amps _0ver 401 to 600 amps
Over 600 amps or 1000-ioTEs
Temporary Services or Feeders
Installation, Alteration or Relocation
X;ry?'U3 Ltcc Cos t
s 8s.00
s 1s.00
$ 40.00
s s0.00
s 60.00
s100.00
s130.00
$300.00
$ 40.00
.00
.00
.00
il8il
Sum
eoo
aSove
he
B
C
1
s40
$ss
s80
see
$
S
s
S
a
0vners Nam
Address 4Sg A r-g'xruru r>e2
City(.ite-kt-,F Phone 3i.i.3-49,qi..
OSNER INSTALI.ATTON
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Onners Signature:
DATE:
D. Branch Circui ts
Nev, Alteration or Extension Per PaneI
One Circuit S 35.00
Each Addi tional
Circuit or with Service
or Feeder Permit 3 $ 2.00
E. Miscellaneous (Service/feeder not inclrrded)
-Each installation
Pump or irrigation
sign/outline Light ing-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OP ABOVE5f State Surchargeftrffir
a% SA*i nisTvq.Tt " Fe c-]bt".\
5b.oo2.60
t.b/,
.00
.00
.00
.00
40
40
20
36
RBCEIVBD B
CITY OF OREGO'U
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