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By; ,, ~ <br /> <br />.Electr cai,Bus. "' <br /> <br />Job Address: <br /> <br />Pf <br /> <br />Regt~lration <br /> <br />~)wner/B,Jilder <br /> <br />Etec. Permit #' ~~;~t~'/ .... <br /> <br />Electrical Firm: <br /> <br />Phone: ' ' ~ _'Address ' <br /> <br /> Directions to Jo~5: '" ' ,. <br /> <br />No. <br /> <br />Amount 'Received <br /> <br /> Residence wiril <br /> , Residence wirlng'l.,. , <br /> <br />__ Electri[ <br /> <br /> Temporary' C~n <br /> <br /> CommerCial Or Industrial: <br /> Service not over 100 ampeK~s ............ , <br /> , Service o~;er 300'amperes but.not more'than,~00'am~eres~,.~....~ ...... <br /> . Servlce'0ver 200 amperes but ~n0t more'than 400'arhp~r~§' .;;....;L.'.'. <br /> <br />· ~ ..... @ $; '25.00 <br /> <br />Service over 600 volts ............................. <br /> COMME <br /> <br />Not more than <br /> <br />, , Fe <br /> <br /> A $10.00 Label shall <br /> A. <br />-- B. Each suppl~ <br />C. Each farm bu.ilding other than residence .... <br />D, Each irrigati,on pump <br />E. Each electric ~ign or'outline, Ii <br />E. Each residential'swimming <br /> BRANCH 'CIRCUITS' <br /> Qne new i;ircuit;~al~eration'or,exter~sion <br /> Two or more new ~ircults; alterations Or e~(tensi <br /> <br />I agree ~o <br /> County. <br /> <br />'SIGNA3~URE OF APPLICANT: <br /> <br />,... @'$ 10,00 <br /> @ $, 10.00 <br /> <br />10.00 <br />10,00 <br /> 0.00 <br /> <br /> 10.'00 <br /> 15.00 <br /> ~:. <br />4%~of Subtotal $ <br />TOTAL $ /~- ~//~' ' · ' - <br /> t"e laws of t~e Stat; O~ Oregon and <br /> <br /> <br />