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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