HomeMy WebLinkAboutPermit Electrical 1998-4-10
12/15'97
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ns nm....-. AulhoRzecI ~\~ ~~I>.\.\. ~"'~ "e, ~~ PDlUT APPL.lCATION
SPRINGFIELD, OREGON 97477 ~.~,l"::~'~\':' ~v..\\ n~r;.'V q 7 / 7 ~ ')
.......~...0If UQUBSTI 726-3769 \y..\'O~e ..,'C.'V\)~'V \>.~\>.~'01"tY Job NuIIlbu )' ""\
OmCB: 726-3759 y..O~\" O~ \'0 '
\>.\)\ <,-~Cr;.'\j. !;9Ifi',LBTE FEE SCll!DULB BBLOV
1. 1'~ION t1P. ~TIOr OW-W-~~" ~~Wv~
(51O'n 'il1fif K.Y\O \ Ct ,~CI'V')1;. lIell Residential-Sinile or
'\>.~ ' Multi-Family per dvelling unit.
~{)"~ ()2.(X) L_ Service Included: Items Cost
~(fio~~r~~ Va~ V~~Wj(e.~
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if york is suspended for
180 days.
2. CONTRACTOR mSTALLATIOK OIILT B.
~RSIFIED ELECTRONICS
Klectrical Contrac ,-., - 'r~B" ...eee""'R
.._..__1 .. r"f~
Address P.O. BOX 40548
CU\,;CNC, UI"\ ~(tt~
Cl ty Phone '1f3<';-Cf07fil,
Supervisor License Numb<i~'!:fl1i:z.:Rf-:
Expiration Date "0, .. . '...." -..
Constr Contr. Number Cf8'ILJC
Expiration Date
If In r-.
1000 sq. ft. or less
Kach additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
Modular Dvelling
Service or Feeder
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
Ree.OMect Only
Sum
$ 85.00
$ 15.00
$ 40.00
S 50.00
S 60.00
$100.00
$130.00
$300.00
S 40.00
C., Temporary Serviees or 'eeders
Installation, Alteration or Relocation
200 amps 'or less $ 40.00
201 amps to 400 amps $ 55.00 :::::
Over 401 to 600 amp. $ 80.00
Over 600 amps or 1000-vorts see "8" asove-
~s_ _ .
- i'r':'j") A_ i' n~ D. Branch Circuits
Ovners Name trllS o (.v 't':1.J.X~tnr.tLltf-
cr-f A C Co L-- Ie f-/.. 1/1':1, fI, lIev, Alteration or Extension Per Panel
Address J 4' I;;;,fj ~....r if . ~nU2..-
v: r. I [</'iJT1 70 One' Circuit $ 35.00
City)' U'-dJ./\ ~ _ Phone""" () ":, -u() !lach Additional
_ (;" Circuit or \11th Serviee
OVllEll INSTALLATION or Feeder Permi t
The installation is beinS made on
property I own vhieh is not intended
for .ale. lease or rent.
owners Signature:
~Ti;------ljtt-ln=r~~-------------~
lUlCIlly~ 'I ' . il) ti ~-rt
~._ 811 7:-.' '/7/A~
.
$ 2.00
B. Hiseellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Siin/Outline Ligbting
Limited EneriY/Res
Limited Energy/Comm
5. SUBTOTAL. OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
S 40.00
$ 40.00
$ 20.00 /~.on
S 36,00
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