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Permit Electrical 2006-3-7
225 FIFTH STREET. SPRINGFIELD,OR 97477 .' PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PllRMIT APPLICATION City Job Number C.OmQOo0 - O-o;;(7S . . '.. " . '. ..,' '.., .' """,,' "',;',",.n. I, LOCATION 8f)INSTALLAVOJ\l7i\';::; i;.,": lY 5 /1 51- 'O(f:Jt :tf" ' '~', . , LEGAL DESCRIPTION \ 1 03 ~s 3;;2. 03d-OO rf~sO~~;vy Olvq( fir" J'o b) I V Permirs are non-transferable and expire if work Is not started within 180 days of issuance or if work is Suspended for 180 days. . I" ~ . .' "" ',~""'~ .>~. ;'," .,.'~r~t["'H(P ...~..,l;"~:-'~...,l:(" .."<'!~:tNl."1'~'Jl!:ra .' CONTRACTOR'iNsi'A'r'rATION:ONL:Y:;, 2., .' ," '.:~.' . ,.'''''~'.:~~,'';<'\<;(;\- "J:' ."....,... t" '.~' t' J-= . _ . ..J.: .. ,_".,,,, .. .... . .._.,;,.., .~_;t.t.L_t!l:."",.,."\.",a,JO:...t,,j>...lih Electrical Contr&~RELL BROS. ELECTRIC 'P.0, DUX uY7 Wolterville. OR 97489 ~11 7472721 Address City Phone Supervisor License Number Y 1 ") I 5 /01D7 Constr. Contr. Number 'J ':) (, L/ t-f l.J /0/D7 Expiration Date Expiration Date '~'{)~i"'6~l Owners Name I JllA,V'p 2 :\-\1 \ \ r<o.dev Address :2-145 C'~ City ~-f'1f\R, Phone Ms-(p340 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 l\,~~~~~&\ ~\.Y fQ ~ Date .- 3,tRq~tP.~~tl!i!!:E~:~SH,fP,~ML()~'; ... ";' .1 '.!'.:w:"f;>,,:,~"~~,r,'~,';:ll'.!:!:F';j .yv' i';::'''l,,:~,:':''''';' , "'1t..~ -,'- '" i:",' ... _, ". " .. A. ~'~~~,,:'R~~!d.~~,~ial :i;S~J1g1~}>,:~' ~'J~lti:::F,a.ri!.il:(pe~~~~'dling:unit. .' ~..-,......'~_4~.....1.lI..,.",....I..__..,<,...""_"",~,,,,,,,,,,, '._ ..'~'. .._.. . Service Included 1900 sq. ft. or less Each additional 500 sq. ft, or portion thereof $106.00 $ 19.00 . ~Ct~K~\~;~~;~PIRE IF THE WO~OO ifUlIDr THIS PEKMII I" l~{)i APT, \;j"OQ\7~,o.,!,l.NJ)~. I;L""..."i'ii:i....,I:(\[F'..-...., .. ,.... . B. ;-.\;'11.; ;.r!:i!.i~;,I..q(~.....4i" ~:' 'S1A.b1ia~~&&eJziifibri~ '01- Rcio~ation: ~ : ~~e,\",.cc, ,'.ar1;!i!~, R oWi"",.,q.".". , "'," .,,, ... , ,.' v@.i'''J.t'.l.lll:iJ..t}:::,_s:1S1..~..w.l..!' ...I".:'., J,".'_" ''',.fT "..;,-,.......,_.:. i, ~~.";>..' _, ..- ~ ",' " HJV 180 RAY PERIOD, ZOO'Anips or ess 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. ;: r;~p~~:f~l~;rry!~~L~~tf.~~~,F~:iK::;~:f~.'~ /"\:~.>~. .: :- Installationj-Alter:ation oar RelOCatiOn! ", I L:.l..., IIUI'J; regon law 'equjl"~C' \/f"'U to~ IC""'l\ 200 Amp~~9.rj~~~ule~ adopted t,,, - $ 50.00.. JU.uu - 1 ,,'.... Vi E'f]nn lltllHY 201 An\p~!9i~!l.Qj6:'Pl!Janler Th u _ . $ 69.00 . \,;...... . '-"'-'v Rrp snt fu, HI 401 Amps]0\69Q,bE'e~1-001 0 t"-- -, ~,$100.QO ^ I.. ~~"" ~AH ~~;e>-Gv 1- ~~~~_.~~?:~~I~r~r~:'.?,eOJ~?~~s:~7_~~:.~J.i:~_b_O~€;: th~ rules by D. , Bl'an'c1i.eircuits1@$~i)tj'jlj,.{f.JOle:tl)e tele'oh,,'1e """n'uintiefl6i fl\e'6'r~~o~ I )tl;-'I i' ' . New Alteration or Extension Per Panel y lOut ceotlon '-''''"1101 ,~ ,-SUO-;J;J;e>-23..,') One Circuit $ 43,00 Each Additional Circuit or with Service or Feeder Pennit $ 3.00 . ,., h __"', ~~ .I, , E. . . Misc'elhlrieo~s (Service/feeder' not included) -Each Installarion .' . .,~.. ~. ,'".,. ,",.. .:;'.. ,,: ' .. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges . .'-' :"' "'.": ':,: ,." >~"" -, 4. . SUBTOTAL OF ABOVE: ,L:J7), (5D 4.60 ( ") ,(51) 5Q,6D 8% State Surcharge 10% ,Administrative Fee TOTAL Shared Drive(T:)!Building Forms/Electrical Permit Application I-06.doc