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HomeMy WebLinkAboutPermit Electrical 1998-9-23 U31 ~~/'UI ~,,: 4D VDU,,) -, il':O ,.)IDOU ~rl"u Ur..~~.. ;:tL""<<. '2lU".l. ;~~;: ~J'd:~ f~ ~",., AaFlELO , , . .. '~-.. zonl~~( ATTENTION'O ' ' t -.. l)11li, . fOllow ' regon law r '" DatA ~~ NOIl'f' ~ules adoPled by Ih eqWres you 10 ' \.. ~"cal/on C e Ore'g" , ' uthorlzoo Signature ' enter, Thos ' on UtII/1 125 FIPTII STREE ' =y,~52-001-0010Ih erulesa.!.e~CAL l'BRHJ:T APl'LlCAUON SPRINGFIELD, OREGON 9747T- ',oumaYob/ain ro~ghOAfB952'001 QO\ I"2J\ INS. "'.......ON REQUEST; 726-.-:fTfJtjl9 Ihe cenler (Ncop/es of Ihe r61&5-fl :Job NWllber ~\.0..Cf-. OFPICE; 726-3759 nUmber fOr/he 0 , ole:lhele/e_ Y .. , Ce . regon ~tilirmtm PEE SCBBDULE BBl.(IlI' 1('\ J,.OC~N OF :ni~ALI.~'l:ION ntens 1-800-332_2 '" IOn '-'\ \ \ '0 I '\oj7 ~ (\()\ I I ~~] 'A. ~W~R, esidential-Siogle or . -... ," Mul t;i-Family per dvell!ng un! t. 1~~"U.QN.n~A Ser'{tc.e Included:' , 'JU..Y.J.J-\0 ('Yt1.I. y,_ .',. Items Ct,st 1;';' -i>-".-; SUIll <6s 'IS 1006}sq.ft. or less I Eac~Jadditional SOO ,--t-- '~6~1:~for portion > Eac.K~Hanuf'd Home. or , Mo4\1lar 'Dvelling Se~yice or Feeder .., Jf:;;: Serv.1ces or,Peeders Installation, Alterations or' Relocation. ~ I J'~ DBSC~P.~:qo/.! YlAq 3 r V D N~I(' J... ~ r\F-\ .' pe~ts ~re non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. S 8:~,.Oa S l~; .00 $ 4(1.00 2. v,.......\ACTOR INSTALLATION ONLY ,B. Blectrical Contractor8ob F.'sJ,er C Ie.Jnc.' Address.Lf'{) K/IIf."bu7.)fj IJP. .' C1tYP,~- -~'. 7).... Phone~!79- 7..223 Supen1sor Li canse Number :Jq '7,5 - . c:; ;"..;, ;~t, 200 ramps or ,'less 201 ~mps to 400 a~ps 4Dl 'amPs to. 600 amps 601 tamps to ,1000 amps OVeri1000 amps/volts Reco!lnec. t Only Wi C. Temp'4'rary Services or Peed'3l:s Installation, Alteration Or R"lc"ation i~ $ 5(1.00 S 6e,.OO S.LOe,.oo $:1.3(.00 S:IOC .00 $ 4(.00 Expiration Date /t:> - /' - ~? Constr Contr. Number 9tDd 76- Expiration Date /..... .;;1S--eJ(';) S 4C.00 '10 $ 55.00 $ 8t.00 vol tG Gl:e qB" above / 200 ~,IlIPS"'or less 201 ~ps to 400 amps Over[401 to 600 amps Over~600 amps or 1000 . .~6- ~ ; j~~ ,',. ~ ,L D~ D, Branl:.h Circui ts ,,; .. Ovners Name *" A\,l \ 0 ,~ t~, . o...~ , nA,I'\ C- ()'fICfffew, ;.,:'A!teration or Rxtensi(lfl E'er Panel Address~}.l I I'Ck J 7'l1l ,fO. 't! " C ", (\44 fl '. 'SPER~Jle Circuit S 35.00 Ci ty [.1 'fi1\.Q.-, Phone' I . -L-Lo~HORl~ 'llafeli4;A,d!l~.tional \\ OOM, ,"'~D~,*r.'i~XB.4qJ;.Y,lth Service OVNER :rNSTALI..ATXON A 'M~N~ElJ rIi:'~~'fflJ;. ~e'rui%' W. $ 2,00 Ny 1 tili " OF! IS:' I~:i PERM 'O11/( The installation is being made on B~Ypt~,ce~~~{!re~/fee6er not included) property I own which is not intended -BIlEYlfiilS'mfifr,iAii''I.lT for sale, leas.. or rent, ' Pump ;,or irrigatl'lSff $ Sign~Outline Lighting $ Limi toad Bnergy/Res S Limited Energy/Comrn S ~ 5. SUBTOTAL OF ABOVE 5% S~ate Surcharge 3% Administrative Fee TOTAIlJ :?:.: ;>':, I 14 '.~:'" Signature of Supervising Electrician 40,00 40,00 20,00 36,00 , 7 r.D , .. ' . /,0 --,--'----y.so -'--s":io ___~~o Owners Signature: DATi~-------q h..? / ~ i RECEIPT 11: '\)}? t...1..LLi.J ',f ,tcQw,...tOwi Dy: . .71.1/' IA.lAoJ' IcLy