HomeMy WebLinkAboutPermit Electrical 1999-4-7
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apP'oval. quire specific land u.<E~CTRICAL PERMIT APPL CATION
97477 Zoning. Q. ~ fDro1J/A.i4?/r;;i -"
7i:l\,TJ769 J./ - 7 _ "7 ') r....ty Job Number~~~~
IIJ'horized Signatu'e _ ~ COMPLt:_U! FEE SCHEDULE BELOII . *"
1. LOCATION OF INSTALLATION
YOln\ 'fYV1 U> ~, A. New Residential-Single or
Multi-Family per dwelling um t..:
Service Included:
Items Cost Sum
200 amps or less $ 50.00
201 amps to 400 amps S 60.00
401 amps to 600 amps $100.00
601 amps to'olOOO'(amps $130.00
Over 1000 am:p~Y:vo'ltsV GI::e-nn S300. 00
Reconnecrq oiiry'delei'~'I!/!ln uM8-rsSt!tf)r 00
,-IO;.;~~ ~41 10 ~ ,eIOiV).3JO eqlJ~eO
C. TempOraI'Yo,~er\v!;ces 'f:ird<feedtFtige;) ~Jeq'"
f RS ilVUR. "" (J/bl eln~. "4.Inu
Ins talla't,' n, eA;1otera'l:(l~n 'orq'R~locB",om/,l
'.'/! n u06 "/nJ e '0100' "Lu no " ;)
Olnnf eJO S04'.J. -IOn !.-\ '08
6-28-00 200 amps orie.'i\;; ~ e41 An._ 'Jel~ '4'@.'s@~' 00
_ 201 amps to 400 Oanips'?I" ~_"'Iaop :::'s'!\:l!ru VU Uj
fS~~ Electrician Over 401 to 600 amps ~vueJ~'N~a~i~ ~loiV
I, ~~/ /~ Over 600 amps or 1000 volts SaeiV~~~MbOVe
~mA-/' SD. ~rancJCircuits
_JU/ct edl ~ .
New, teratlon or Extension Per Panel
Address i.\Dta\ VY1n. ,'....... ~,
CitY~I\:<Y1~~QM Phon~o-~ L
OIlNER INSTALLATION
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
I ('OJ-~SJ;rf'0~(j {~O ()
JOB DESCRIPTION
~~ol ""'Y'>r",,;:bb-
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days,
2. CONTRACTOR INSTALLATION ONLY B.
Electrical Contractor Sonit,ol Security
Address P.O. Box 21009
Ci ty Euuene
Phone 461-5678
Supervisor License Number ~n~'~
Expiration Date lOlqq
Constr Contr. Number 65149
Expiration Date
Owners
Signatur
of
-,
"
The installation is being made on
property I own which is not intended
for sale. lease or rent.
Owners Signature:
I /
D~~E~------~f-~--tZfqr-------------
RECEIPT ~:~.:z~'k~'-
RECEIVED BY: ---,VI\' WA./' --
--,
1000 sq.ft. or less S 85,00
Each additional 500
sq ,1>.1f'nor.tport ion
thereof' "'~; $ 15.00
Each Manu1R'tIllH~!i!AlI?EXP/RE IFTHE
Modular Rwen1,n~~r'. WORK
Service or Feea:e~- fHIS PERM$!' ft9N~'
'ANDON-O
Services or Feeders . I c: FOR
Ins t1a"ila0fi~R ~ r'A"..t't~lrk t ions
or Relocation:
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm --1--
not included)
$ 40.00
$ 40.00
S 20.00
S 36.00
ZY/J,cD
5,
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
-::<.Lp.ro
\ ,'60
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