HomeMy WebLinkAboutPermit Electrical 2002-6-10
LEGAL DESCRIPTION
1703 'Z-ylf'3.
E E&AL PERMIT APPLICATION
oh Numher 02.-00670 - a I
IPLETE FEE SCHEDULE BELOW
I.
New Resiuential-Single or-
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
JOB DESCRIPTION
Abu S-
c...: <Z-c.>.A : +-5
1000 sq.ft. or less
Each additional 500
sq, ft or portion
thereof
Each Mauufd Home or
Modular Dwelling
Service or Feeder
$IOG,OO
Permits arc non-twllsferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days,
$ 19,00
$ 50,00
2, CONTRACTOR INSTALLATION ONLY
B. Scn:iccs 01" Feeders
Installation, Alterations or
Relocation:
Electrical' Contractor
Address
/
/
/
200 amps or less
20 I amps to 400 amps
40 I amps to GOO amps
60 I amps to 1000 amps
Over 1000 ",ups/volts
Reconnect Only
$ 63,00
$ 75,00
$125,00
$163.00
$375,00
$ 50,00
City
Phone
/
/
/
/
Supervisor Licen~e Numbe, V
~~\
Expiration Date
Signature of ~uJlcrYising Electrician
C. Temporary Sen'ices or Fceders~
Installation, Alteration or R~~Q.1l
~ ~
200 amps or less ~".~~ ~ r-..~
20 I amps to~~~~: ~......
". Over 401 to a~~~
Over 60~~ ~i'~ volts see
, , "8" abQ,,~ ~ o..~v
'0/ f>:J~ ~v
, D ~4~~~' '
Owners Name. T I yVlC[AIA6-tflIA( ~~~~~'r'~ Extension Per Panel
7')' . .. L ~ #.~(S ~ it:- I.)
~"'(... ~ r ~ ~'S'iilt ' ~ $43.00 Lf
~ ~~'" ' .' \-;"..,
'Phone 7 2b -1..f!frG ~1 Additional Circuit or~:itl\~~AJ~'\";,;;:
or Feeder Permit,,\'~ O~0' ,E- t1:2'$'3:Q.Q fl..
/~ 0 c:.~ \)-- ....(!,cv
.V ,o~ ,s,0 '>-<(-. ,v' $
E. I\lisccllancous (ScJ""\'icclfc~dcr;.,\l\oto(ihth"drd)...\!3~, ,.,~
. ~"" QV ;!)'/J' , . :>! \\V
-Each il\staIJa~i6'n ~ 'f::\~Q ''O<c,O 'I.~e,,~c~
, pumpiol~[jigt\i9fi~~,\)~ c,o<i~ei,~0 ,~O~~?O,OO _
Si~!Y,Qu~t\y~~~~gJttingj\~' ~O~ J~\\.~n,~$5Il,OO _
LlIlllted<Euer!r\. '/ResO ~e\' (\o~ (\~[I, $25,00
.,,' '1,)_........4,'\.... 0"'''' 0~ cv"- -
Liliiited$uergy/ConUl!,O\ a.~'V $45,00
. U' ""\'-"~"'" ~'CI V":) - -
, , E"I...rl~?~'p"\~q,"\dQ\~.P.~\<c,, F 'S4- (II) S I
I\ll1l1mum cc nc~ cr:mlt nspcctlOIl cc IS -~. + lire lilJ"l,,'CS
- ~'l.I ..,
,,-:> ,,-
4, SUBTOTAL OF ABOVE SS
7% State Surcharge '3 S'!"
8% Administrative Fee, o..j 40
$50,00
$69,00
$100,00
'''Const, ContI'. Number
Expiration Date
Address
Z;l{'2. ~,
Citv SfFc..0
OWNER INSTALLATION
The installation is being made on
property I o\vn which is not intended
for sole, lease or rent.
Owners Signature:
~Jamp/ll1', I'1ClAmcA~
1:90 :I33Ih~ h u
: 39NlJH:J
1:L'~1:8 $ G:G:J3~ lW~
GOOG 81: NOr:31lJG
8G96000-1:0:~SNlJ~1
TOTAL
b30"