HomeMy WebLinkAboutPermit Electrical 1999-8-26
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; 'as you to
, ENTION:Ulb"v':' ,,' - , : -
ATT 5 adopted by the Oregol"' Utll,ty , .
225 r.l.r La STRE..."T fo~I?W [-ule Center ThOSe rules are E'mEG'l1RICAL PERK!T APPUCATION
SPRINGFIELD, OREGON 97477 Notlflca Ion. -0010 through OAR 952-0Q1' CI .
INSPEcrION REQUEST: 726_JVi69AR952001 btaincopiesofth6G:ii.leyPJob Number /1/N. ~
OFFICE: 726-3759 _ 0090,~ouhmaYOter INote:thetetephone '. '
call1ngt ecen '3 cq~tB:EE SClIEDOLE BELO'l
1. 'LOCA1'ION OF INSTALLATIONlumberfortheOre\lvnU,'2" '2'3'44)
C t '51-800-33 - ,
2....2...8~ N l).6G~\.V.4-.... en en .:A. Ne'J Residen tial~Single or
I Mul ti-Family per dvelling uni t.
T f"~AT. DESaUPTIpN t:i Service Included:
j(jfl '3 6 ~ / '-I 0 ((PU Items Cost Sum
1000 sq.ft. or less
Each addi tional 500
sq. ft or portion
Permi ts are non-transferable and expire thereof
if 'Jork is not started vithin 180 days Each Manuf'd Home.or
of issuance or if vork is suspendeNcSorICE' Modular. 'lNelling'
180 days. . Service or Feeder
.. THIS PERMITSHALL EXPIRE IF THE W~RK
2. CONTRACTOR INSTALLATION ONLY AUTHORJZ~9 U~~~"f~ ~s .
n. \' .....J(''O~~DO,J;a.s: aci'6vii, ''1; H!ratlons
Elee tdeal Con trae tor't"\'1UlQ<;' t..l~ 'O~, 1<l50R
rJ 1),.,..,Ll- _ i' ".. .ldO AYPERIOD
Address lJ..'-IS ~ \ I'\el ~I\/.e. 200 'amps or less
r , I I 201 amps to 400 amps
Ci ty. t::U..9\Q,(\O./ Phone &SR"1.t'I::2. 401 amI's to, 600 amps
o " 601 amps to 1000 amps
Supervisor License Number ~1IqJ1 Over 1000 amps/volts
I /.q Reeonnee t Only
Expiration Date I O{fll L'_P-.
I I ' , C. Temporary Services or Feeders
Constr Contr. Number~-/1CJ(J, Installation, Alteration or Relocation
/0/(;( /qp,
, .,
JOB DESCRIPTION
-:fNSl'ftLL- l";aoeYl- ()~rL.:r
Expiration Date
I'
I
SignatureGpe,;-~sing Electrician
\'- ~H4'it. PlhU(:ls
ItJ/.I(/(sh tlM. /"tC{ I
Ovners Name~",vr"If)l1mpy,.f ('off),
) ,-
Address p() 130x c..f 7cZA
Ci ty ~em}, DR 17'1~one W?:5-f?OO
0'mER INSTALLATION
The installation is being made on
property I o"'n vhich is not intended
for sale, lease or rent.
Ovners~s~gnature:
S 85.00
S 15.00
$ 40.00
S 50.00
S 60.00
$100.00
$130.00
$300.00
S 40.00
200 amps"o't' less S 40.00
201 amps to 400 amps S 55.00
Over 401 to 600 amps S 80.00
Over 600 amps or 1000 VO.Lts see "B" above
D.
Branch Circui ts
,.
Ne'J, Al tera tion or Extension Per Panel
Miscellaneous (SerViceifeeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
E.
,
, ,
DATE: ~/ 2.(,( T '/
RECEIPT 1l':
Dt1rT:''T'lT''!:"n nv.
()'~)}L{<.J
5. SUBTOTAL OF ABOVE
~7~% State Surcharge
;; ~)(' 3% Administrative Fee
~ ~n~AT
/
3~..!;:1-
S 35.00
$ 2.00
S 40.00
$ 40.00
S 20.00
S 36.00
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