HomeMy WebLinkAboutPermit Electrical 1993-8-9
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P'-h'l. 'JaG not raqui ~ltteBhE~CAL PERMIT APPLICATION
., re pecilic7a~;; TOlloWlng q' fA(')
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Dc:;r:ng Ci ty Job Number :\ \( '_
225 FIFTIl ~TRlmT
Sl'IUNGFIELll, OREGON 97't77
INSPECTION REQUEST: 726-3769
OFPICE: 726-3759
Au",. LJ::! SI . COHPLETE PEE SCnEDULE DELOII
1. LOQT.1QN Ol\-iNfI\*J.LATION gnature-lli
\ 9','-\-' I ~ ]V, VU III / F .J A. ~al-Single or
., Hulti-Family per dllelling unit.
\~JfD3E~l~~~ n,qa) Service Included: Items Cost
Jon DESCRIPTION 1000 sq. ft. or less
Vf"/n::;:;/~A L5~"-?> /f'~~,Each additional 500
. .. ( sq. ft or portion
Permits are non-transferable and expire thereof
if lIork is not started IIi thin 180 days Each Hanuf'd Ilome or
of issuance or if lIork is suspended for Hodular DlleHing
180 days. Service or Feeder
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2. CONTRACTOR INSTALLATION ONLY
Electrical contract~~Q-^I~h\ ct~
^ddl:ess~f)~ ~ l~o ~ ~ ~"d
City &x!RJ'10 .' I'hone~4~-12fi7
supervisor~icense Number \ KIQ...x ~
\CJ. \,qS
Con"tr Contr. Number c~M-''?1 \
Expiration Date
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Ey'P;~~:;;?t~ ~~~i~~9~
Signature o' Supervisinit.lectric1an
g-~ &~~
. OIlU N~~ ~t ~ 0 ~ V\ c>>
Address croo to . '( ~nul
CltY~J'one
OIlNER INSTALLATION
Sum
$ 85.00
$ 15.00
$ 40.00
D.
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps'
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
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
$ 40.00
$ 55.00
$ 80.00
volts see "D" above
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The installation is being made on E.
property I own which is not intended
for sale, lease or rent,
Owners Signature:
---------------------------------------
DATE:
RECEIPT #:
HECr-:rVED ny:
~""9 ."'<.~.
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I Alteration or Extension Per Panel
One C l.reul t ( $ 35.00 7.S--
Each Additional
Circuit or with Service
or Feeder Permit ? $ 2.00 ?
Hiscellaneous (Service/feeder
-Each installation
P~mp or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limlt~d. Energy/Com~
no t included)
5.
SUBTOTAL OF ADOVE
5% State Surcharge
TOTAL
$
$
$
$
s?/.~
"2~--
4"":[ ~
40.00
40.00
20.00
36.00