HomeMy WebLinkAboutPermit Electrical 1993-04-19IaC'TY
,GFIELD,orv
225 TITTE STREEf,
SPRTNGFTEIJ, ORBGoN 97477
INSPECf,ION RBOUBST: 726-3769
0FFrCEr 726-3759
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ELECITRICAT PERHIT APPLICATION
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Job Nunber
A. Nev Resldentlal-Slngle or
Hultl-Famlly per dvelllng unlt.
Servlce Included:Items Cost
1000 sq.ft. or less
Each addltional 500
SQ. ft or portlon
thereof
Each Hanuf 'd ilome or
Hcdular Duelllng
Service or Feeder
s ls.oo
$ 40.00
Permlts are non-transferable and explrelf vork ls not started wlthtn 180 days
of lssuance or !f vork ls suspended for
180 days.
2. COII1TACf,OR INSTALI.ATION ONLY
ct
Super vlsor License Nilmber MaS
Explratlon Date tm@ tol,lqi
constr contr. Number D&t1q
Expiration Date t&
Slgnature of Supervlslng Electrlcian
0vners Name
t,\ill ?.taorrorE PEE
'.EEDUI,,
BELos
Ik
Sum
Electrtcal contrac.r, L. P5ytbharvr f*
Adaress tS \r-r h Yirft-
Servlces or Feeders
Instal}atlonr Alteratlons or
Relocat lon:
200 amps or less *,
201 amps to 400 amps
-_401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Oniy
B
&$ 50.00
$ 60.00
$r00.00
$130.00
$300.00
$ 40.00
C. Temporary Servlces or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps _ $ 55.00
Over 600 amps or 1000 volts see I'Brr above
Lddress AryrUrRru La*l
Ct ty Phone Qq;,&D1a
OIINER INSTATI,ATION
The lnstallatlon is belng made on
property I ovn vhich ls not lntended
for sale, Iease or rent.
Ovners Slgnature:
DATE:
D. Branch Ctrcuits
Nev, Alteratlon or Extension Per Panel
onecl.rcuit I $35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. HisceLlaneous (Service/feeder not lncluded)
-Each installation
Pump or irrigation
sign/outline Light ing-
Llmited Energy/Res
SIIBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
(
$ 40.00
s 40.00
$ 20.00
s 36.00
RECBIPT
RECEIVED
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