HomeMy WebLinkAboutPermit Electrical 0-8-21
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C;ate _
725 FIFfS ST.RE~r
sPtuNGFIEW, OREGON
INSPSCtION REQUEST:
OFPICE: 726-3759
9747f;"ulur/zeo Signature _ ~
726..:H69
e~\"'.i'.tUCAL PERMIT APPLICATION
-
City Job NUClb~rOO ~oo '63/- 0 t
COMPLETE FBE SCaEDULE BELOV
1. LOCATION OF INSTALLAtION
L03 CD C ~+Y"~e+ ._._________
LECAJ.. OESCiUP'l'ION
__1,033 SlY. OZ,~
loa OESCPJPTI0N
.J:.'le.L.'> ~t:(;2;~ V.o.c. ~jQ.a.e-_,ha..1D.:
Permits ate non-trar.sf~rablp. and p.x~ire
if work is not started within 180 days
of issuance or if work is susp?~ded for
180 days.
2. CONTRACTOR INS'I'Al,l.A'rION ONLY
E lee: t ri ca 1 Cc';\H l:'a c t 0 l~ ...D.:J:il;l1.t~ _
Arlch'et$ ::<-'~ ?"~k_WM~ '
Ci ty/,~_ I)hone P!/i..f;'ZIJ~a..
SupeL.visor I,.icense, NUi1l~er 3l,;JH.-:S_
l;;x p. i l'8 t ion Os. t e "10....:/___0 (,_ .....,.
Constr Contt. N\JmbH__MJ5'4.J
Expil~ation De. t€_ 'I.-{'iS::.,Q.L_______
. 51'W.'. ^ Of:~~. El.erfd clan .
. :!:;;Le..::_.3.<<L 'i?r=:~:<' u
Addtess 13b<6_.2Io/c-'> __ "S i._.,__
Ci tY~~Vl (;(; ?h0IH: 3'12_=- b.'1;;-6
/
OtINER INS1'AI.LATION
The installation is being ~ade on
property t own ~hj~h is ~O! intended
10r sale r "H:!a~~ or r~nr,
Ovners' ~,~gna t; u reo ;" '
....
DA=tF.~- ..- - Q~?~7oo:"~ -,.- ~__=.--"- - -- ---
RECEIPT ,~.. _ ,~..crP.'7..__..,-,__...._._.._-
P2CEIVEO BY: _.,_....b1C _, _ ,_____..._.,__.._
3.
A. New Rasidential-S1ngle or
Multi-Family per dVel1i~g unit,
Service Inclucl~d:
r'~l!:ms Cost
1000 SQ. ft. ,or less
Each additional SOQ
sq. ~t or portion
ther.eof
Each Manut'd Home, or -
Modular Dvelling I
Setvic~ or Feeder
-.
B.
S~ryices or Fe6d9rs
Installatio~, Alterations
or Helo.-::a t iOI);
200 amps lH' less",
201 amps ~~ 400 amps
401 'amps tb 600 amps
601 ainp.s to 1000 ~ml'$
ov'ei: 'lOOo.ampslvol t,$ :-:-----
R~connett Only
Sum
S 85.00
S 15,00
$ 40. 00
.$50.00'
S 60.00
$100.00
S130.00
$300.00
$ 40.00
c.
Temporary Services or Feede~s
!n~tallation. Altetation or Relocation
200 amps' 'c'r leo,ss"
201 amps to ~OO amps .._--
Over L.Ol to 600 amps -'
O'!,=r flCO amps or lOClO-vor"ts
..-"~
"
Sranr:h Cir'c.u;! ts
Ntw, Alteration or Extension
One Circd t
Each Addi tional
Cit~ui( O~ ~lth Se~~ice
or F~~d~r PGr~it _ 1_
E.
Miscellaneous (Serviceli~eder
-Each installation
Pump or irrigation _
'S,i gn/ en... tl ine Li ght ing
Lind red EnergylRl!!s' ._-
Limi tQO E.n.t~y/~~m~~~ ,____
S. SUBTotAL-OF ABOVE
,XState Surcharge
, 3% Admi~l~trative Fe~
TOTAL
$ 40.00
$ 5~,OO
S 80. 00
see liS" abOVE
Par Panel
S 35.00
S 2. . 00
not included)
S 40.00
S 40.00
$ 20.00
. S , :11,. 00
" ,':3: --I ..
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