HomeMy WebLinkAboutPermit Building 1999-4-6
. .
fOllOW rUle d .' ,- - .-
N t'f s a opted by the Oregon Utility
in ~~~a~~~ Center. Those rules are set forth
009 -001-001? through OAR 952-001-
O,',YOU may obtain copies of the rules by
ca Ing the center (N t 'th
22.S FIFTS STREETlumber for Ih ,0 e.,. e telephone
SPRINGFIELD OREGON 97417 e, Oregon UlIlIty Notification
INSPECTION REQUEST: 1'26~3j69'800-332-2344).
OFFICE: 726-3759
20'l!
approval.
Zoning
'taJ2"..d6.\:t pt:"t)UTT
Aulnonzed SiQllatute
Ci ty Job -NWlloer
L.~ r'C-
AI>!>I TCATION ~ - (p - 'Ii
0,1 C II't~ ,<.0
;';~:;;;;~;;;i;~;:;~i:;;o:nitc'ost*" !II
Service Included:
Items
3.
1., LOC,6JION OF INSTALLATION J
r..2..-43 r7 A/;;"" '..FiT 7
LEGAL 'DESCRIPTION
/7 03 7,<:; LJ.I
A,
6 '6 7 &-7)
S H:l.OO
1000 sq.ft. or less
Each additional 500
sq, ft or portion
:;;::.thQr"of
(Each Manuf'd Kome. or
=Hodular 'Dwelling
~Service or Feeder
IT'
Services or Feeders
Installation, Alterations
or Rcloec.tionz
JOB DESCRIPTION
.A--7./ 6'/2 'f.- /T /V/
.>"'::/-v/Ci
S 15.00
Pcrmi tt are non-transferable and e~pire .... -l
if york is not started within 180 days j u~
of issuance or if york is suspended for .5 "tl
180 days. ..j! ;!;1 gJ
~q~3:
:J oB.,.l
.:) c en
::oz:I:
0)>
..... ;J) m F
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m-rlx
J>:I:1J
City~PRINr,F1FI n Phone 726-6701 is ~ ffI
~gJ::;;
m~~
,,-Im
O(jj::;:
-'-' zCO Temporary Services or Feeders
~ ~ .Installation, Alteration or Relocation
$ 40.00 y~' 0 rJ
/
2. CONTRACTOR INSTALLATION ONLY
"
r.i
Electric"l Contractor Able Electric::o
Address 5511 MAIN
S 50.00
$60.00
S100.00
$130,00
$:i00.00
$ "0.00
200 amps or less
201 amps to 400 amps. .
"01 amps to 600 amps
601 amps to' 1000 amps-----.
Over 1000 amps/volts
RQconncac.t Only
30235
Supervisor License Number
Expiration Date
1 0101 IAq
Constr Contr. Number 92506
$ 40.00
S 55.00
S 80.00
see "B" above
ExpiL'ation Date 7/16/99
200 amps"oT less
201 amps to "00 amps
Over 401 to 600 amp~
Over 600 amps or 1000 vo!ts
Si;nature of Supervising Electrician
,/ ~
-<5
" ~
--
<-" -
Branch Circuits
D.
OVnersName /;t./?/t L-l.L"J.:::.G/7
/
Address /LL-"; /"" /)/:,./ 5'!? 7 }
City 5/'l- L/l Phone 7 'r/Y 7tfJ"
'OVNER INSTALLATION
.'
Nev, Alteration or Extension Per Fanel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder ~ermit
S 2.00
E. Miscellaneous (Service/feeder not included;
~Each installation
Pump or irrigation $ "0.00
Sign/Outline Lighting $ 40,00
Limited Energy/Res S 20.00
Limited Energy/Comm $ 36,00
5, SUBTOTAL OF ABOVE Y cl 0 :-
5% State Surcharge dol. -
3% Admini..trativQ F"Q I. d. /J
TOTAL .l-J3. ~
The installation is being made on
property I own wnich is not intended.
for ~alet leasp. or rent.
Owners Signature:
---------------------------------------
>-1- (p.q "'l
~.
DATE:
RECEIPT 11:
RECEIVED BY:
"'1'3 '1\I./'l/.
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