HomeMy WebLinkAboutPermit Electrical 1999-9-1
ATTENTION:uregon law lequlles you to
fo~l~w ~ules adopted by the Oregon Utility .
Notification Cenlel Those rule~ 9'" ~~. '~"'h
in OAR 952-001-001 0 through O'ELECTRICtu: PERMIT APPLICATION
/-1M ~::>~-U01- ~
9~;~7 376~090. Xou may obtain copies Oclhf' 'umN b ? -r-(=o 9902</3>
- calling the cenler. (Nole: the tele~hone um er
numberfor the 03~go'CbH'piJB1iBtimiCSCHEDULE BELO\!
1. LOCATION ..QF INSTALLAT}:}JN " Center IS 1-800-332-2344).
/'1tJ6 ,i')/;'; rY7/Jnd /h8~ ro/1avr,. A. New Residential-Single or
~ . Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
11~3,~2~ Off~K
. JOB DESCRIPTION 1000 sq. ft. or less
/, rn " b d "/1" rf 'f / <;' ~/?/./r /-11:,( Each add it ional 500
AI sq. ft or portion
Permi ts are non-transferable and.Qli~E:'.' . thereof
if work is not started within l~t~~g" . Each Manuf'd Home. or
of issuance or if work is susp~d'~fTSHALL Modular'Dwelling
180 days. C HOFlIZeDu ea-iiWf~fP or Feeder
OMMeN NDeFlTl-/1 n-tet1.\ij
2. CONTRACTOR INSTALLATION O~lIN 18 CeDOfllISA~ef:$f'5ftMm.<I lflMers :
. - ODAYPE:FI 1i-M'.tllliA/m.!:..!?'r\,091terations
Electdcal Contractor/Jvlff7,jlld /;/lI'lrtJnl"SJP- or Re'1o"'tM.E!n:
Address Po 13th- 1/05(/,{ 200 amps or less
201 amps to 400 amps
Ci ty 7" /./9"tU' Phone...lLK<V- t:Jcz..zZ 401 amI's to 600 amps
. 601 amps to 1000 amps
SuperViSOl" License Number ~qq/ jLE Over 1000 amps/volts
Reconnect Only
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFPICE: 726-3759
Expiration Date
'O/C;q
Constr Contr. Number 1J1?/t/5
Expiration Date q 'II t'}'O
Sign
lectrician
~, ,:.
Owner~ Name _\' +m. (h ,'11 , f f J() n <;(if II P If lfY1
.
Address q~ 5IJ i-Inl.{fil n 8, ir/qf7 ,0,.
Ci ty ~fi.u" Phone 5'7 0 -/'zJI't
OVNER INSTALLATION
The installation is being made on
property I own whi~h is not intended
for sale, lease or rent.
Ovners Signature:
~~TE~-~---'9~~1';---------------------
RECEIPT #: . I' 0 'Srfi '1/ b
RECEIVED BY: ;tU/ tIfI ~
It ems
Cost
Sum
$ 85.00
$ 15.00
.$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration' or Relocation
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "Bft above
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$ 2.00
E. Miscellaneous (Service/feeder not included
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res --L-- $ 20.00 10.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE
57. State Surcharge
37. Administrative Fee
TOTAL
.~O.~()
I , 0
, " 0.
:2 :2 . () 0