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HomeMy WebLinkAboutPermit Electrical 2014-3-25 (2) Electrical Permit Application DEPARTMENT:.NSE ONLY i ,, .` .„, i -,i, '.rr I `4+ e- n ,,ca .aC TYf t„ PRINGFIELD; OREGON ) .. t n : �� — / ry � ;E .,r i _ , -- ,, w, i �.„. . ,,, ,tip ,, . Permio 225 Fifth Street•Springfield,OR 97477•P11(541)726 3753•FAX(541)726-3689 - Date: S tZ j //q This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. cJjriMxsL`OCAL,','IGOVERNMENT'?AP,FR'OVAL- f" : `., _ = r s' It nz€ek,1�-1"-,;FEECH ED U LEhVi, it xK .,t ��t 9 L r t :-- t,yat x§d i z1 +;Oo5t (Total Zoning approval verified. ❑ Yes ❑No Number of Inspections,per Item O Qty 1 's,ea s -cost.'.c ` ' :CATEGORYt:OF, CONSTRUCTION ^ ,,k ` de Residential, per unit,service included: Kesidential El Government El Commercial 1,000 sq.ft. or less(4) $147.50 $ r0. `JOBcSIT ;1N FORMATION-AND;=LOC ION;;;r_.,,,'. Each additional 500 sq. ft.or portion Job site address: Cat) Mr/4//�J 442: thereof - $ 27.50 $ City:%p -Jr� JQ 7 State'�rM, ZIl'Z , e Limited energy(2) $ 35.00 $ Reference i 1-� —I1 -m/9'VPaxlot Each manufactured home or modular ,.- Sa,,st?t,vS�)Y`�iD C'IRTION 'OF;'WORK`; s^ k '.•-d:^ �' dwelling service or feeder(2) $ 69.00 $ _ S M ..� J;a..} �J / .�/1 O. /�/ �� e I Services or feeders: installation, alteration,relocation • �/� • s^ _tr or i 200 amps or less(2) $ 89.00 $ .; +,; -yP_O `„ TY„O ER '" ,`)'q a' 201 to 400 amps(2) . $ 104.50 $ Name: ' G ' /Pr�`r t„ , I T 401 to 600 amps(2) $174.00 $ Address:f U O q� 7 /`t�et!-Q�/ x 601 to 1,000 amps(2) $225.50 $ City: ` State: 6t, ZIPf Over 1,000 amps or volts(2) $516.00 $ Phone/ Q68r 129 Fax: t- Reconnect only(2) $ 69.00 $ E-mail: ein4r /'' / C net) Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) 5 96.00 $ property o Mended for ale exchange, lease, or rent. OAR 479.54 1) 479.5 (1f 401 to 600 amps(2) $138.50 $ Signa re Over 600 amps or 1,000 volts,see services or feeders section above �:4't': x''.`'i`. cONTRACTO^R 1NNSTALLATI. , ) r�','',? tZ415-;„`^,'. Branch circuits:new alteration, extension per panel Business name:���,V 6 " - a. Fee for branch circuits with purchase of a service or feeder fee: Address: Each branch circuit $ 6.50 $ City: State: ZIP: b.Fee for branch circuits without purchase of a service or feeder fee: Phone: - - Fax: - - First branch circuit(2) $ 60.50 $ E-mail: . Each additional branch circuit - $ 6.50 $ CCB license no.: BCD license no.: Miscellaneous fees:service or feeder not included Signing supervisor's license no.: , Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: Signal circuit or a limited-energy panel, $ 80.00 $ . alteration,or extension(2) Each additional inspection:(I) _ $80.00 $ t'+':h r' - +y x5 4PPLICANT Till SE x`+ ; . ,li', `<' . (A) Enter subtotal of above fees $\ (Minimum Permit Fee$80.00) (B)Enter 12%surcharge(.12 x[A]) $O 0- (C)Technology Fee(5%of[Al)' $ ((((((14 0,9 TOTAL fees and surcharges(A through C): $ q3SS1- 440-2584-1(4/01/2013/COM) ■ • • Quick Plot Page 1 of 1 • y »+x - a a, X 4292690 624740't�877136 862547 ��" ,�i`� .—�Y c ,pe1}. .., y_47 +1 'q°"x 4'.7.:e‘,.,74.1-r A3• q k �" al Mw° g 2 t r A ,,,, 3 t sE x rif ; �X y4. ' ;ii.:^ yi' ' t �i • arv. .a .a c r.a. 4-‘, 't8 I:' �?t'+ --:,' .,....1,9----.ti o- ti t aiity .: + f a t Est\ ? 4'' 'r ' ic„s„ .t . r r -:./.,:::'::-.` .t r t T: hT*� t3,,. f 'f-.'.r j� v s � ' j " y 3 4 °w. j{k'" m i ,w E ' znr d t''' - w •"� F i o r 'S "ar "fib y t_.* ta• . ,r ' _ y !lam ,v_` Y .;6:-f.:11 IR 4e zoact, 'k t "`e �" ,`it' '4'.w k q:4:34',_„ac:f!' ,.Ifi'7 t✓},.e y 5- } + It't _ �' E-v, . T skF :.. ' �•q 5�'' y1�� ( ' F a v % 4c t, - c. , '' + s_z 'S" Rt s ° ,.A± s'st+ 4t , y �- T ' ypfa- t`Fe3--t��,ff}� � �a .t '" .�''�� f 3 f t �,• l': g' v I a:. +yy 9 1 f rF ix 4i 3 o' ei 54,-, ♦x F.y/ r 'tr. �. t. °�t e � .i .� 'i w ..-Y b .'� t. lF�.� yrjl c:4 ` ,, 1"?-1"'''C ' r [' Gass Ems : t _ N. 1 •t!!: i1 Fr r I its«. • °S'1k �. 2 i —a' i3 _ t ]+'u fl Mli w p f It z l t T x ax1 .' ...-!2'T-t A � o +"d6� ,�t $s ��� � � 3'� .a }.+ � i w � c e T'y • _` ,, I-ts t f,-",t- 1- t'Lp:i Car k .} 1 fN`+ttw + t l y` } n, r- '' r;� L.r. Q 1 ',..:!,-.;:::.;i4 3s•..1Y U. ISt iyt t.• ..41,'-'‘:U t vs •q``6*: �..r }°';r' s C5'. . -I. • s ' m- Y Y t` ..'j5 Y .�.77 4 'f y k.,, 7,H' • 2s •�. • ti k:..• s:�, E= o- uCS :^qa } .`s;� ^k tt ., 4'".... . . .. t` �r• ...,. The materials available at this web site are for informational purposes only and do not constitute a legal document. • http://spifs047/mapserver2013/mapviewerajax/quickplotpreviewinner.aspx 3/25/2014