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HomeMy WebLinkAboutPermit Electrical 2004-2-25 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~,(~m~lil/&tas submitted has the following ELECTRICAL PERMIT APPLICATION zOning, and does not require specific land use 11 _ approval. ./ City Job NumbercON\ z.Q)t\-~OCO\l Date CY2-c.1\:-O,-\ z '. I.AJ..1. _' onmg ... ""'. '" "'. ,.,....... " ... ,2~:2...c:;--oJ- 3, :COMPLE.tf.f1f!!'S;;n.c..u'-'Ll'.ML{j>~~~,.;-....,/ JI' Authorized Signature ~\.,A.....:J Installation, Alteration or Relocation 200 Amps or less ,,\,0.., $ 50.00 201 Amps to 400 Amps 0'" '\.), \<i$-'~;"<$ 69.00 . 40 I Amps to 600 Amps 0..'/ ,,0\' c..0" ~'I 00.00 _\",0 ("\,\0-_(16 ~'" '\ Over 600 Amps or 100Q.>Vol\!i'see~B'<....6'6ve..\0~ ~, ;. .'!;' ~ ~0 ~ "\'" ~~ D, ',Branch Circui~9 'Q':\ ~ ~v ~O ,~0 :<,0 . 0<;0, '" .. .. O~"" C' S~ ",. !\ - 0~ v:- _' .0 .~O, ~~ 0 ~ ~\v New Alteration",qNExtensl!'P'Yer~"awl. O~ . <<\v 'lJ.v- 0\' C'" O~' >'S' ~ One <;;i~Ul~0~. ,,~~ C"!=>" ',(\ G .";' ~t.\ .~~t$.43.00 Eac!f..Xdd.lionallClFcUlt or<wllhl"O . \'" 0," q 17u ~ .>\' ~, <" ..'0' " v~.,.. $ () Serv;~a"'or'~edef-Pernfit 0\' ,,0<;0, ....n 3.00 - \0' 'v'l> S" 'IJ.'l ~~ ~0~ C""'" ._.. ~'~ qj- ,:, (:< . v0 0 </-" , .' Address d5tJ::I ^ A.A-l~) c:::: -,- E, l"4~,,!,.rlhn~s (~Jhi~.!'lfe.d'er not included) -Each InstaUation '7 '<;o,,,clll()'~,<;o,~0\\0\>/ ,. ....- City {;;.(Z, NbA~ Phone 7'-1 l-J -9, '-1 I r Pump or irr;g'll'~ r' $ 50.00 · SignlOntline~ghting $ 50.00 OWNER INSTALLATION Limited EnergyfResidential $ 25.00 The installation is being made on property I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ID)~ ~ ~ ~ W 1~li ou Owners S. nature: n\ 4, SUBTOTAL OF ABOVE 1:7 3 - FE B 1 9 2004 7% State Surcharge /0 7.2. 10% Administrative Fee It; 3J'. ,-{OSaOrH"i '..-,,-;. l,... 01 Inspection Request: 726.3769 TOTAL 17CJ- I. ~ . -. - LOCATION OF INSTALLATION. .\. _ ". ~u 50. Jt '.,".\ ';;;'0;2.7 <;r LEGAL DESCRIPTION /7033" tf :2.07306 JOB DESCRIPTION /?/'Fr t'r: aU/LfJ/Nr..-- ~ 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. ~QNjii1c!OR l!!.STAi~TIgN~NLY' Electrical Contractor k?:~/7o/cl; 8~r./. otiC. v Address >>75 b/ ..z aZ City ~K.f' Phone 3<13-72-"77 Supervisor License Number cfl S;<O ;.:::.<5. ~- R:;' J c? J 0 '-/.,\-<:'~? ~ / s<,." ~,.. ~,. ~ Q<5S:',<5) <<- Consfr. Contr. Nnmber !<.-{? ~ ~ ~'v\" .,.',>-<:- 'J;."V Expiration Date ~. ~ S~~'S! ~ 'Nv ~,. '0'-' \J ~, S. ~'I:~..{.{Q.: ""~ -ofl 19nature uRu0sin rtCl~'" ~S ," ::\~ , ,~~.3'~~ ",v ~ .. -__ I!s~<) LVM'?'@<"" Expiration Date -....4. . - ."-'. ,., _ "- -' .:,,; ~'1' -, ... . "- -;. . A. i New,.Residential- Single or 1\1ulti-Famil); per d","eHing unit~ .' /~, '. _ _ ,",/ _"..,1 "_.... ..... -,. ; l., l;' _. "_ , . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 '.. - - . . .. . --- -. .-, ~ B. Servi~e;: or',Fe~de'rs ~ iitstaliati~n, 'Alh~rati"oris-()~ "Rei~cation: '-"'(:;"~--'.-,-,.~_.~,,;..~ ;., ~_"'... ,'....:~--~. '.'." 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolls Reconnect Only I 3 0'" Co - $ 63.00 $ 75.00 $125.00 $]63.00 $375.00 $ 50.00 r, -'-.; ,""...,....< ,. "\, y" -~_.,-;- ". I''':;'' . , . ,", "0 C. , ~~~lP.o~arY:. ~~~"jc:~,~..o.~. F~e..(~.ers., :'); . ... Shan.x1 Drive(T:)!Building Fomls/Ek-ctricnl P~nnil Applicalion I-03.doc