HomeMy WebLinkAboutPermit Electrical 2004-2-24
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':m ; IHrt STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAXz:s1 ~e~~~~:~~~i~~~~~i~ l~en~I~~~lng
ELECTRICAL PERMIT APPLICATION approval. I.. .
Zoning o<...M" .'
City Job Number LoWl"Zooq-Ooo i 7 Date 0'2. I 9 0 Y ~-';'I-o.f
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20'Z 7 s. A 'S+
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ownd:m: ~OSBo(u)
Address """"'0 Pc")v 20 E. ~~lli~ll',ffi~b~(~~~~riff;;'?ft<gr1ri'clt'aid)[Lifcli'Ii~1lill~'tiok;1
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City _ S?1<.i 'V 6+1 tt.~ Phone Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50,00
OWNER INSTALLATION \\lOTICE:~, il(:fi~e~r~IW@"WfHE WORI< $ 25,00
THIS PER II lea L rnm"roiaJ..
~e in,stallation is being made on propeny 1 own whicjl,UTHORI UI~ ~ff. nftlVlfl IS NeT . $ 45.00
IS not mteoded for sale, lease or rent COMM\!1iroE\9 flINISi*IWM!!Ftie:9lFee is $45,00 + Surcharges
Owne- S,'gnature'. ANY 1 Alii;.;.;"'" ''';~:'':_;''''''~'''''':'-''\''''l'~';');';''II)"',,,"a'f~'''H;r.I,
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LEGAL DESCRIPTION
1703 <., ?-'YZ
JOB DESCRIPTION
073()O
ft:'Wlf'
?cx..J c-<L-.
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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,;,CON.~Kd.(" ,'QKi>INSTA1fl:f;1TION;ONL,"
2. t.l;t.,.c,'~' .. . ."..". ~ '. . '-'"" : ,~rl: "';,.."
Electrical Contractor 1fewholdS Ot:!'d. .A,c..
(/ .
Address .7/ 75'" 1/1/. .2.- ~ A tIE' ,
City Jf5,."/?,,,-e
v
Phone 3 If 3 -72.. '1 7
Supervisor License Number ~ 5";z.. C) - 5
Expiration Date
/0/0 Y'
I
/ 7 z-S- Z--
02../ OS
I
Signature of Supervising Electrician
Constr. Contr. Number
Expiration Date
Inspection Request: 726-3769
A- rL~~~~iii€~~ffigf~~~~iJff(~_p1~W~t:{~~_pl~g~~~h~q
Service Included
1000 sq, ft. or less
Each additional 500 sq. ft. or
ponion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50,00
B. .a's~~~~:ide~.![.~,tin~~Xt~B~t~f)i~tstiRo'ii~H
~~~.u:tkcl...,..';'...:e.~'!~~~~li'.I!'IL~=~~;"~
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 Amps/V olts
Reconnect Only
$ 63,00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c. ~'flm"or'a"':Se&ceSfor:reeiie'r's~,'\1I!liir.!i,';l_m~"1iilii~
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Installation, Alteration or Relocation
200 Amps orless I $ 50.00 5"0
201 Amps to 400 Amps = ~6\'l.l\9
401 Amos to...;tlll'~"""sagon laW ,"'1.....-" t.1M1l9
II \ it:.f~ I~~'lf"olr' ..... - ="'rrtr\..rti
~ 1fil 'e~ bJ; tll" c,.-,,- ,
, ~,;,i,~,Q!,',o;,:,:;_,,:,:,,.,f1I'., ~..;;';,;~. ~e" 'l~~~ set f~~~g!(f",.,'~lf~,7'~L,
D. !t .,., utr;~tp, ,~, ~.: ' '.. ': .,.' . ,~~.. :I;:,;"%~!itt;,,~~,
" =
,OAH ? - ,_ ~p:"s 0 ne
Ntfo.i\ll~r'fgBI\"'!l.t:xtension 'Pe ~,~~ telephOne
One elffi~\Iih9 I,he center. (Not\je,:....... ~,nt~ita{\QJn
Each Ad . 'n"o16f'" itw\vt1li'n ,....,. --
serviP~Jl}~~~r'pu:"i~ 1_R(\(\_~::\2.2344)$ 3..00
7% State Surcharge
10% Administrative Fee
5""0
]$"0
5"00
'S"8S"O
TOTAL
Sbar~ Drivc(T:)IBuilding FormslElectrical Permit ApplicaJ:ion 1.Q3.doc