HomeMy WebLinkAboutPermit Electrical 2005-8-5
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (~4i~t~-iB~~M
ELECTRICAL PERMIT APPLICATION I
City Job Number CDt'Yl~ - OloPb Date ~I ~ Ios:
1.
tQ04 Cd.r+er l4Dl~
LEGAL DESCRIPTION
l-r O~ 2--5 7:,2- (~100
JOB DESCRIPTION
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor\)ou.3 \)0.. \yv\p/v Z\ ec. +A L
Address 'i3l\ z.. . 1-6.( cl fu .L
City 'Zvt~ ~ V\L
Phone t.\~.-9.0D ()
Supervisor License Number "L \ L\ L S
I D I, /'LOtJl
.
O\Dl1-~
Expiration Date
Constr. Contr. Number
Expiration Date ,~:A~ \ 'LoDLD
Signature of SUtZPiSing7;2lec "an",
/ tS.
/ .
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I / .
Owners Name <J i cX.-t (bope.-Y
Address \904 Cc.-Y.fe--y ~
City~ri~'~ Phone
OWNER INSTALLATION
....-
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
3.
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion ther.eof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
B.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
I
"3. (){)
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50,00
c.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D.
$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per Panel
lit
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E.
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited Energy/Residential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
b3.oD
4.4-1
to.3D
7PJ.7(
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building FonnslElectrical Permit Application I-03,doc