HomeMy WebLinkAboutPermit Electrical 2003-4-22
o CITY OF :,..~luNGFIELD, OREGON ~~,
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION! \I 'ng proiect as submitted h~S t~ent~l~o:,ing
C. J b N b 7 U 27/0'< Theta OWl d 5 not requi,e speCllC a
tty 0 urn er rnwl zeD] ~oOOz... Date -f "Ie ~ zoning. and oe
f I approvaL Lt::fZ- ---=-
3, I COMPLETE FEE S,-..~;".."fju 11,HO.w4-1!I-()f3
Date- . -~)
- A, I 'N"WReside~t'l~V'~'I;itgfC'I.';~~lti~j?~,\,lily per dwelliilg unit.
2. I CON1'RAC1'OR INSTALLATION ONLY I
Electrical Contractor SlEUE HMe,JL
S t.f6-th st
601 Amps ~1&~mps
aJ,\- .1l'~5 00"6.~~ij~~'?f~
\~-R~c~~~\ J:::F:J\
.s .0\rtl~,o\i \~e J~S ~:( .9'~~ ;. '0)
~ 7'1- ."' ,0~' a<)9\e~~o$ef~~~~~~~~or Feeders
:<)'(:.'~ ~eS<J. ~e\' \:J~\O ..eSO rtt:e9. 'S..\O~
) D - I - bWo'll \~ ^~ c,e vrf:J\ \~flfr~_!t\'ti\ ~!#i'~n or Relocation
J Ii., (_~~\~\C~9~'2..,.\l\:J~i O'O\:f.~S\~'h~~b.'\' $ 50.00
Constr. Contr. Number -, T ",,'l"~~'<'_t"\) ~ ce~\!O,Q,~c;fm#i~oo Amps $ 69.00
f I '\~\:J9J\:J' ~o(:\~\\,e\\~e. 4QI~PS to 600 Amps $100.00
., - $0- 0.5 c'<>> \\0 e\\S
\)"'~~ c,e~\! Over 600 Amps or 1000 Volts see "B': above.
{\ D. \8...lOch C;,-cuits
I. I LOCATION OF 1N~i1'A1LA1'10N
) L{ L 7 SrI...- st-
LEGAL DESCRIPTION
/7 () Z. '3 S"'-( (
00600
JOB DESCRIPTION
c-yn::7V tJ .:t...
C((2.c..v..t"+-
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
Address
~~fJ
City 5fr;'}J ~~IJ
Phone
Supervisor License Number
Expiration Date
Expiration Date
Signature of Supervising Electrician
~nP ?~
v
Owners Name ~,,~ ?h~ Ilf
Address /47 7S"+L..... 5+-
City -::>f r D 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
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
B. I Services or Fee4ers - I~stallatiOli? ;\lteratio.ns or-Relocation:
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
New Alteration or Extension Per Panel
One Circuit , . j $ 4~00
Each Additional Circuit or with 1"f\t. \NO?;
Service or Feeder Permit ~\?\t..\~ \ '<2> ~\}1l0 .
~1" 'V ~'J; -~Jl.~\\.c.
E. ~ ~\\~li'S~~~~f&~~*\rt~) -Each Installation I
~. l'i:.\l~. S ~'O
Pu~!~~~\) Q?\ \ ~O'i). $ 50.00
Sign(,~m\~ll!l~jt.?; $ 50.00
Limit~n~lklReSidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection fee ~UrChargeS
4.1 SunTOTALOF.ABOvE I
l()
L(';-
7% State Surcharge
10% Administrative Fee
7(J
'(10
S'Z- bJ,:.
TOTAL
Shared Drive(T:)lBuilding FonnslElectrical Permit Application l-Q3.doc