HomeMy WebLinkAboutPermit Electrical 1999-8-4
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225 FIFTH STREET ,:;,.;,,-,,,,j~t..~3~r2uHb' ELECTRICAL P'ERHIT~~PLICATIOlI
SPRINGFIEW, OREGON 97477 !flJ\9w rules adopted bytheOregol}.'JII . at YO(
INSPECTION REQUEST: 726-~6HffcationCenter. Thoserulesare~tfY< Job Number -, V
OFPICE: 726-3759 I, OAR952-o01-0010tQro~gtlD~M~iI~E SCIIEDUI E 1lI~1 Oil
, '~o . You may obtam cople's'81~hlH1tleE . "
1. LOCAnON OP INSfALLATIO lIin9thecenter.(l\I.ote:~eteeJ!~)rE .
4020 11/t.a./N ''.:7.tErf~reg&t"Uti' 'N(\m IM,ntial-Single or
-._0" . ..,,,. .)~, ,tt " 'amlly per dwelling unit.
LEGAL DESCRIPTION Service Included:
/t()2'?/1(1 1)01./06 ltems Cost
Jon DES~.~;ON 1000 sq. ft. or less
Sf Ill//el e '3 <> cut.e.. 'I~~TICE' Each addi tional 500
v v . sq. ft or portion
Permi ts are non-transferable and exT~I8PERMITSHJlI!.te<fllREIFTHEWORK
if work is not started wi thin 180 depf1lHORIZED,&.l!l<;~R':W.lJgb'&,.IJ/fI1h,.R5T
of issuance or if work is suspended lor v'Wo'iiular 6.r.rl''ff!!a-.
180 days. COMMENCEDOf.l~~il~QQNiiIU:Mif
ANY 180 DAY PERIOD.
2, COnfRACTOR INSTALLATION ONLY n. Services or Feeders
Installation, ~lterations or
Electrical Contractor ')I--\b (-J (....Linu Relocation:
Address.N 1':S'1 l)"Yl ,<:,+- 200 amps or less
C:, ;- 201 amps to 400 amps ---f-
ci ty 0! )C.+/ r:i Phon e::J!J '" ---t./.hSJ:; /,01 amps to 600 amps
- ~ 601 amps to 1000 amps
Supervisor License Number 314'/{- S Over 1000 amps/volts
Reconnect Only
Expiration Date
10 - I. 00
Constr Contr. Number <-f....<.I2...C,
Expiration Date .zt'2.LLOD
c.
Temporary Services or Feeders
Installation, Alteration or Relocation
Signature of Supervising Electrician
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
~~.~
Ownel's Name 6-17t...<--t ;.:?t. b~
I __ ,.
Address f2 ( S /;7'/"
Ci ty 5,1V Phone 12t~ 71 S r
OYNER INSTALLATION
D.
Branch Circuits
*
Stim
$ 85.00
$ 15.00
$ 1,0.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
.l&_
$ 1,0.00
$ 55.00
$ 80.00
volts see "B"
above
New, Alteration or Extension Per Panel
One Cireui t $ 35.00
Each hdditional
Circuit or with Service /0
or Feeder Permi t 3 0 $ 2.00 r,
The installation is being made on E. MIscellaneous (Service/feeder
property I own whiclfhtIPIIA'0i~g61RA1Gt1dlJdbmitl.dhasthefellOanr@ installation
for sale, lease or fll\'i~I!' and does not require specific lan'Nfitil' or I rrlga t Ion
. approval. I / 1 ' . I i
. S gn Out lne Llg It ng
ZOning . 1 '. d E /R
u I,~.e 'nergy es
Oate l.iw.i.1 ed Energy /Comm
Owners Signature:
Authori7p.n ~ign:lh'r""
~~~;~-------14-!r1------~-'----'---"--
RECEIPT ,: ~ ii~/io 'if,
RECEIVED BY: ~ PV~
5.
SUBTOTAL OP ABOVE
~ State Surcharge
11" TOTAl..
7],
not included)
$ 1,0.00
$ 1,0.00
$ 20.00
$ 36.00
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12- VI
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