HomeMy WebLinkAboutPermit Electrical 1998-11-25
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Date~~. "T~J STREET ~Cqllill OUI11 'O''''O'Or. 7"11 'Ytlle ~~CTRICAL PERMIT APPLICATION
AI ,,~ OREGON 97477 'beY tile:; 061. ~'O tll~~e ruJ. Or~ ~ YOv.
. "i:NSl"'EcrfmrJr.UUM1. " afortl1 &l}terCi'1}Co ~U{)II~8~~t/;,9b Number q ff/lfS f
OFFICE: 726-3759 el}te/ Ore' (tvol'e8 ',q~ ^8et fly
'8,.. 'lJoi9 e: ~gIlP~'I'i~ll17~CHEDULE BELOII
1. LOCATION OF INSTALLATION 8'O'O"''1t.lt/;'f~te/~/(j'8 '0,..
h 7'fr /lila, N ' 1\1",--<. ~~"j}.;~etl):ial-Single or
, '. ti~.f>mily per d"elling uni t.
Service ~ncluded:
LEGAL DESCRIPTION
/7t'). 3lf<llf
~fJ/ /)(
(JJOB DESCRIPTION
d !'.h AJAI.I ~..,.
Permits are non-transferable and expire
if "ork is not started "ithin 180 days
of issuance or if "ork is suspended for
180 days.
"
2. flliJmc;rOR INSTALLATION ONLY
Ele'c~,Jri.cay, Con trac tor
., .., /"C:N liT SHALL EXPIRE I
Ad8lfe-S'SlRI7I=n I """~r. ~' F THE WORK
COM . ,-- , I n1Cl t"tHMIT IS N
Ci ty MENCi:D OR IS Al'ld f''phone_ _ OT
r~! Y 1 R() r,- UUIW:v rUN
/' I PFR/nr
Supervisor License Number
f
'I
I
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
O"ners Name 1i-7J.""" Pil//J./II,J( m./ltilJ..
I
Address t7 f{) /J//4.,IV
Ci ty <...,,/1.1"4 htf (I Phone 7U. f'fc,t
I I
OIlNER INSTALLATION
The installation is being made on
property I o"n "hich is not intended
for sale, lease or rent.
Ovners Signa'i\re: .
'-1Y)" kO.: n~ /ytPt?o y
~----;i~--------------
RECEIPT If: t,-57..{47 II
RECEIVED BY: AV f/.)MV
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular 'Dwelling
Service or Feeder
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
Reconnect Only
M
'~
Cost
Sum
$ 85.00
$ 15.00
,$ 40.00
$ 50.00
S 60.00
$100.00
$130.00
$300.00
$ 40.00 $2-
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
D.
Branch Circuits
.'
Ne". Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or "ith Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5; SUBTOTAL OF ABOVE lfo W
5% State Surcharge 2- 00
3% Administrative Fee I' ~d
TOTAL f.{ J. ~
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