HomeMy WebLinkAboutPermit Electrical 1991-09-05OF ORECON
EI.J,ffRICAL PERHTT APPLTCATTON
City J ob Nunber
3. CO}IPI^ETB FBE SCBEDTII^E BELOIT
%
Nev ResidentiaL-Single or
MuItl-FamiIY Per dvelling unit'
st'ruN(iFrELo
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each }lanuf 'd Home or
Hodular Dvelling
Service or Feeder
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-
0ver 1000 amPs/volts
-
Reconnect OnIY
225 ilW SmBEr
SPBINGFIBID' ORBGON 97477
inspscrrox RB0UEST: 726-3769
OFFICE: 726-3759
if vork is not started within 180 days
oi i""u"nce or if vork is suspended for
180 days.
1.
Permits are non-trans ferable expire
A
Cos t
$ 8s.00
$ 1s.00
$ 40.00
ee nBn aSoF
s 2.00
40 .00
40.00
20.00
s 36.00
sl-rcPi
to/o1 /)7
Sun
B..'2
E
Address 73 {31 2r uer (ono
Ci ty Phone q%-16t3
Supervisor License Ndmber z'7 5 C-Pf,
Expi ration Date to/t
Llrya
Constr
)e4,Pa'
Expiration Date a-
ture of Blectrician
Owners
Address
ci one
OIINER
c.
200 amps or less
201 amPs to 400 amPs
-
0ver 401 to 500 amps
-
Over 500 amPs or 1000 volts
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 3s.00
E Miscellaneous (Service/feeder not included)
Temporary Serviees or Feeders
Insia1lailon, Alteration or Relocation
obrr*
s s0.00
$ 60.00
$100.00
s130.00
$300.00
$ 40.00
$
$
$
Contr.
Signa ture:
r
s
$
$
c
40.00
55.00
80.00
The lnstallatlon is being made on
property I own vhich is not intended
for sale, Lease or rent.
STIBTOTAL OP ABOVB
5Z State Surcharge
TOTALDATE:
RECEIVED
5 Oc)
@.
-Each installation
Pump or irrigation
Sign/0utIine Lighting-
Limited EnergY/Res I
Limited EnergY/Comm