HomeMy WebLinkAboutPermit Electrical 2006-6-14
SP.FIELD ZON LfY) I
L P INITIALS -:tW-
~,.:.... DATE Ir~O"
~F " SOURCE ,~I~
Date ~-+.\ - ~
3. :'5.2.i11p'LETEF..E~~CHEDUiE BEiow
II
Each Manufact'd Home or
Modul~\fl'reEg Service or $50.00
Feeder-HIS P ,
, . I EBrytlI SHALL EXPIRE IF THE WOR~ .
B, . se.4itlHGflioldiiilrWNOOR\If~II(Snp!I\tJI'11~8-'wo\l-elocation:
. COMMENCED OR' IS -ABANDONED FOR . ,.. -
200 Ain'PV drll~{JAY PERIOD. $ 63.00
\ 201 Amps to 400 Amps $ 75.00
Address ~ ~~} Q 401 Amps to 600 Amps $125..00
601 Amps to 1000 Amps $163.00
Phone 6L\) - (;~I ~CoYl\"l Over 1000 AmpsIVolts $375.00
Reconnect Only $ 50.00
ELECTRICAL PERMIT APPLICATION
City Job Number CD (YlQDO(n -D()Lj.q,
1. LOCATION OF INSTALLATION
'. .'..j\) .:.t, .... __.,...,,"
::A~~SCRIPTI::?~\- W('\,
\~ O'~ 03 14 OIC\OO
JOB DESCRIPTION
~Qlr:>.v~( N~\;J~ \.t
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
. ':'-'--\~":', J' .-, "*.1'~ '-:'!"'. ':.::'~ .....,... -,.,_ .
2. . CONTRACTOR IN~TA!-LATI01V ONI;Y
- . . - .. .... .,- .~.- .. .~-- ,
Electrical Contractor TJ~ ?\ \rl~ LLC
City'~V\)~\\, t .
. , . .
A. New Residential:- Single o~ Multi.-Family per dwelling uriit.
. -..... -.. - '-- . -. - .... _.. -.. - -"~- '. .j.. - -
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
.$ '}9.00
f. .... -,-- ....-.- ~ - .. ---....-~
Supervisor License Number ~ '(J - L \ \ I elSe. r,Te.ml!.olarr S~'rvice~ or F:~e~s '.
.,
Expiration Date m -- D \ - 0(",
Constr. Contr. Number i~C:; ~ I "S
Expiration Date' \ 1) - \ '\ - ~ <-t,
Signature of Supervising Electrician
~
Owners Name
Address -P. n .
City ....:jQr.AJYYlA- Phone
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Installation, Alteration or Relocation
n
$ 50.00
$ 69.00
$100.00
200 Amps or less
201 Amps to 400 Amps
. 40 I Amps to 600 Amps
Over 600 ":mpsor 1000 Volts see "BOO ab~,:e.
D. BrariQh1Cir.cuits... 0 .. " .
-- . . - .-""' '.'I.J1~. regon law re- --. -- .. .
. fOllnw.."If)_OO" qUires you to
NewJ-'lteratlOn or )i]lll~n'slo/l!:.~errl&a8'ileg U . .
one,Cilfiiit'3.',on Center. Thos~ ;"Io~ .._~n$ 4tJ,hfjfJ
I j 1,...'L\ I-J QJ:\':'J ...."., .....r.:l, -.. ~ setttorth
Eacp!ifq1it!~al (t;ircuiturWltl)-ough OAR 9-2
Servlc~or FeedwRerrmt'ain copi -$ 3Qll)J-
c<.!Lno th .. n . b~ VI me rules by
, .. '.. e ce..ter. (Note-- the t r .. ... .-
E. Mi~cell:ineotis (S"r"ice(~el\d~l'not infrlid'Jdy/111:ach Installation
OO-- _OO, 'C -'.. . -,..~u I IIliy4\lotlfication.' -- . .
enter IS 1-800-332-2344)
Pump or irrigation . $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial X $ 45.00
4'5.0))
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. SUBTOTAL OF ABOVE .
4S,oo
,~.00
U. z;f)
53. CO
, '
8% State Surcharge
10% Administrative Fee
TOTAL
Shared Drivc(T:)JBuilding Fonns/Electric<l1 Permit Application 1-Q6.doc