HomeMy WebLinkAboutPermit Electrical 1999-6-28
. submitted has the tol 0 I
The following protect ~s equlre specitic land use
zoning. and does nO ,
approval. I .-D (1-
Zoning I _)..~ - C, "i
o,u5 FIrTH "l1U:.J,;T /!. ~ o.TTEN'IION:uregon ,aw reQUirEtE~CAL PERMIT APPLICATION
$.r.lW;W~~~ DllE{:91l 97" II follow rules adopted by the OreguII ~~';~cth a 0 .
A'f~'tltCT!ON REQUEST: 726-37~~tification Center. Those rules ci.\).2!R,~ .Number f (0 $' 7 'f
OFFICE: 726-3759 inOAR952-001.0010thrO~gh?~H\j:. ^u "
0090 You may obt31n crOOHPlJETE' F~ES gCHEDULE BELOY
1. LOCATION OF INSTALLATION cailing the center. (Note: the tele,~no~e
/~.z r tftcJJe- (~. _~M.^rthe O!t'JorNEiIi',iI~eS:ilij'e~~i'Rl-Single or
~enteris1.800MIf>};'~'i'?,'F'amilY per dwelling unit.
LEGAL DESCRIPTION 'Service Included:
17tJ3 )'f 2- ~ (J)) 60 Items Cost Sum
JOB DESCRIPTION S 85.00
,.",~ J..Ir,..!)
Permits are non-transferable and expire $ 15.00
if work is not started within 180,days
of issuance or if work is suspended for go (fU
180 days. ,$ 40.00
2. CONTRACTOR INSTALLATION ONLY ,B. Services or Feeders
~/' . _ Installation, Alterations
Electrical Contractor.~ ~ or Relocation:
Address /OC(Z ~ rHISP1=q~rr: 200 amps or less
~' , ~ . SHAW to 400 amps
Ci ty ,veL Phone 72-,/ st;:'"",';;,IZEDUN a, IFt1H~o.Q...,a,mps
, c:&--:!.Vl/ytt:NCED ~ (J't)O'it(mps
Supervi.~o License Number f IANY1~A ORIS~ a ~~NlD1.ts
I~ / "'1 YPERI~conne Iiiifi
Expiration Date ~ 1
, /''Z'J2? 02 C.
Constr Contr. Number t/J -' ~~
/2.( 7' T
Expiration Date
, Signat~perVis~rician
I
Owners Name
Address
Fw
,1.(2.&
/lr--nk
,
&.66ft (// ew Oa
Phone iff'!':' 76 7b
Ci ty e P1 C {;; ,v e:
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
-------~-1----------------------------
DATE: 61j.f 'If '
RECEIPT II ~ OS /.ft. S'I J iJ /
RECEIVED BY: IM/
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
"
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional Y1~~__
Circuit or with Servic~~~-~
or Feeder Permi t / $ 2.00
Miscellaneous (Service/feeder
-Each instal1ation
Pump or irrigation '
Sign/Outline Lighting
Limited EnergyfRes
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
.,.i~
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
,<62 ..
't. (0
2.-"Ic.
ltg'. ..-r.