HomeMy WebLinkAboutPermit Electrical 1995-5-2 (2)
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11/18/9.
15: 46 U'503 726 3689
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SPFD DEV. SER.
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ELEC'I'RICAL PEIuaT APPLICATION ,
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Zonina #;P
'225 FIFtH STREET 5-2.-'1<'
SFlUNGFIELD, OREGON rg.'"f47i IJ M
INSPECTION REOUE'ST: A~~'nature' .
OFFICE: 726-3759
':'ity Job. NWIlber
3. COMPLETE FEE SCHEDULE BELOV
1. ~OCATIO~ OF INSTALLA'l'tOlt1 11. UJ
~~tJr) L~m mLJeU.dY WV~ . A.
~~~~)(p~~n :1'r1e-
'J B DESCtuFTIONl/l /II ~ J L
{At... r (,(,.NV II' '
~ermi ts at.~non-transferable and t expf:e
if work is not started 'within 180 days
of issuance or if. work is suspen~ed for
180 days.
Nev Residential-Single or "
Multi-Family per dwelling unit.
Service Included: ' ,
Items Cost
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders'
LIIl 12 A/JI/IA.. /" tr: Installation, Alterations
Electrical Contractor . ~ {:.7f(jIt'U Jlt,ll-'h-,J-1\JLor Relocation;
AddressJJL.1JJ ~rv "'~ , .- 200 amps or less
City SD iJJ. Phone 1tf7'~~,'b tgf ::~: :~ :gg :=::
Hi I" C 601 amps to 1000 amps .
Super,visor License Number Lf' 73.J Over 1000 amps/volts
(.0 . 1 ,/).c. Reconnec t Only
Expiration Date '''T:.I
Cons t r Con t r. Number mlOqq
" L' , ~l tI}.S
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Kanuf'dHome or
Modular Dwelling
Service or Feeder
Sum
$ 85.00
$ 15.00
..
",. ..
-
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00 .
$300.00 -
$ 40.00
/
c. Temporary Services or Feeders
lnstallation, Alteration or Relocation
Expiration Date
200 amps or less
-
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 100u volts
x
,
of SLiS~:Z:iM
Owners Name () 1<. ~ b 0 VL Ge-.D ft1P
Address 3-&6D (~WluiL-a..{ CtV1-
City. 6p ~. Phone 11r:, '';!50C{
OVNER INSTALLATION
D. Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
. One Ci rcuit I $ 35. ~O 35,(1)
Each Addi tional .
Circuit or with Service '
or Feeder Perllli t (_ $ 2.00 0?,tJ!)
E. Miscellaneous (Service/feeder not included)
-Each installation .
Pump or i~rigation
Sign/Outline Lighting
Limited Energy/Res -
Limited Energy/Comm
The installation is being made on
property I own which is not intended
for sale, lease or tent.
,
Ovners Signature:
--------------n----, - ----------------'
DATE: 6, c1) . qS- . .
M~&'.lFi' #: ii i;, J I '-1.:Ji ,
RECEIVED BY:
5. SUBTOT At OF ABOVE
Sr. State Surcharge
3X Administrative Fee
TOTAL
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$ 40.00
$ 40.00
S 20.00
_ S 36.00
31,00
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