HomeMy WebLinkAboutPermit Electrical 1995-3-14
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zoning, and does not require specific. land use
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OPPICB. 726-3759 . Author"'ed Signe'ure 1"}'V'-
J. CUMJ.IS1:A I'd s...............a BBLOV
IlLBC'lBlCAL PBIlIl1T APPLICATIOH
City Job Bumber q 5031 q
A. New Residential~Single or
Multi-Pamily per dwelling unit.
LEGAL m!l:r.ATP'fIOH ; Service Included:
-1:l.0} 3J L'...Lt;J/9-_/ .
\ JOB ~o,l-t I 1000 . sq. ft. or less
(\ ^ r, ~ c\ ~ 11. nOL.o AIlf w ,1-n.J~ ,11,.J.t Each addi tional 500
('\ 0 if . . sq. .ft or portion
peni1'ts are non-transferable and expire thereof .
if work. is not started within 180 days Each Hanuf'd BOIll! or
of issuance or if work. is suspended for Modular. 'Dwelling
180 days. SerVice or Peeder
oJL/lj'bl
1. LOCA7Iotl OF DIST.4LLA'lIOlf
c:; ::rZ, c:; I'Y\n, M 7'S r
B. Services or Peeders
Installation, Alterations
or Relocation.
2. COB'1'IlACTOll INSTALL4'lIOH ONLY
Electrical Contractor /l0E Tnc-
Address~/ l.1Ll~;~,:n(~~ 669
City AM ~ V\ 5, Phone (p (p 9.;:. lc '::J /I
SUpervisor License NUlIber ::) (",(Jl!.. OS
200 BlIPS or less
201 amps to 400 amps
401 amp's to. 600 amps
601 amps to 1000 amps
Over 1000 aJIIps/vo1 ts
Reconnect Only
Expiration Date
Com;tr. Contr. NUlIber
Expiration Date
1()-<1t7
(.LJ4nG
3 .. 5 -CJ &,
C. Temporary Services or'Peeders
Installation, Alteration or Relocation
Items
Cost
SUlI
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
200 amps or less $ 40.00
201 amps to 400 ups $ 55.00
Over 401 to 600 amps ----- $ 80.00 -----
Over 600 amps or 1000 VOLts see -B- above
Branch Circui ts
S~ of Su
Owners NalIe h, fo,f~frV'L
Address {, C; (ej)feIM;Ct!
City &aeJ1L Phone
/
u'......,." lllS'lALL&'lION
"'-- D.
"
New, Alteration or Extension Per Panel
One Circuit I) $ 35.00 :;:(00
Each Additional
Circuit or with service3
or Peeder Permit $ 2.00 ~.DO
B. Miscellaneous (Service/feeder not included)
-Each. installation
Pump or irrigation
Sign/Outline Lightin~
Limited Energy/Res
Limited Energy/Comm
/3/tr./
The installation is; being made on
property I own which is not intended
for sale, lease or rent.
OvDers Sigpaturel
DATE: 2,-/{..(-q~
pRnITPr Ii I{,,~-Cl" 1 i
RIlCBlVBD BY: ~L~
ZOOIl!l J
5. SUBTOTAL 01' ABOVE
5% State Surcharge
3% Administrative Fee
TOrAL
'IIBS ., ABU lJ.oIdS
690C UL COSQ
"
S 40.00
$ 40.00
$ 20.00
$ 36.00
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44. .29-
00'90
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