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HomeMy WebLinkAboutPermit Electrical 2005-11-15 (2) H.T. . SPRINJI!-lS/Jtj " i' .. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICALj'l}RMIT APPLICATION City Job Number COt'\1 '21>05- OIlL-JIZ- Date I. "i_OCA110N OF INSTALiATION. . :";." '.>. .~ -. 1 ~_ ',~. ':, '. _'-~.. _ .' ... ....-<:. - _. '.: ","0:-'.1< , ,::) () Z 7- 5r9t>./I, A, ~ I. m3W LEGAL DESCRIPTION \(t()3~ JOB DESCRIPTION Sec.U"f';k --' ,<';(",;1 tier ~;lorr0 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. ):PNr,," 'RACi6~jN$T#01;rP.FJ OlY1:f ", _ '. =- '..... .'''- '...... .::_" ..-.. --'->>-"'- ~ <..--'....... -~'!.. Electrical Contractor '<::;~LllYeTec.fA IJ1L Addr.ssSll/ /Va I-~""i 4 E I [Jet City E ue,(J~ Phone <:;L/' 2g3 T v Supervisor License Number ~'<?~ X'~ l.. (;A, Expiration Date /f) - 1- 2009 Constr. Contr, Number / ~.'-7;'&/~ 0_ c., ZOC-' Expiration Date ,...., () . ,.. Signature of Supervising Electrician ~/2~- . - /' Owners Name ':;;::'C,t~Jt::r2~~P",-i--R('. Address PO. l3ci' 2D CitySpYi~ Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 . 3, "CO~IPLET:lFEE'ScHim;;LiBEiow;~'T7-,. . - :.":,,. ~ ~.'~'.;j'< _-~.~..:.. "'.. .:-..,,< <~.... d'" ...._,.,;;:,..;J.~:- .J ," ~:'. ':::S A. ~ 'N'e~\'- R~s'i'd~~il~~'sf~~I~'~f-' ~'i~lti;'F;~ii)~ l~;:~..~:~lii~i u'ri-i~':"TC::: ..,. _. "'-'." '..__._._ ..___,....,.... ........ ,_ __ ..... "-&"'_"_-"-'-"_m_"'~-'-.'''''''_ ....-<.__. Service Included $106.00 1000 sq. ft. or less I\{ fi'''1,1 additional 500 sq. ft. or THf}HGli~ereof AlL~mM1fa<$fl/Nt?J11~'?J,., CO WlJ..RIi~&'1!}fIJ{jE~,fiee>JRE IF THE INnn,.$50.00 MMEwCED 0 THIS PERMI fll1\' A~: :1e#pA~ #~~<~~~Qg~f~S'~2i~~~?<~'iii!~~aii~~:-:'~ __ __u~~...=_ _u. .0.,'1 .l_._..~...._ ~...:. _d.. .._ _ -~_.:._~.... $ 19.00 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/VoIts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375,00 $ 50.00 {;~..~' "'1'.,,"." : ~'0h, ;A(-:;:."'" '-'7'--r:""~": 'r-"{f'.'" ,-,.- c. (! :Tritipor~r~';-Ser:Vic.~~ #r',feedcrs. ,;~: ~ > . It_. _" .,....-.'~, ~,~.-___,_ """L,."", _",..J_:;t ,I'..._........,....._~_ Installation, Alteration or Relocation 200 Amps or less $ 50.00 ATTE~9-1 Amps to 400 Amps $ 69.00 fallow 40/19!'n\j,9t,f600'A:mpSreQUire $100.00 . ru €IS adopter! h,." ~ S yuu lU .1IIot/ficat.~y~xy6.&8t~J\.~rh~.19~?;.~;J~~.~~.r~;(~UI~t~,~,::ri_:;' ~-~! ; :'.:_":"':,:::r,- :'"'__.- ,~'1 In OAFD'5'Branch C, Ircuits'>~, "",EI,S ~,~. ~';l'''''''' . ,.;. "",.' v.. '.." "" ' . f:,:" I~ '1.1 ^j""__"",i;",,",I~~"-"'1. :J:ih(!:J"'.t,.." ih.<-C--" ,,(.' 1 0090. Ym,';:;,Y~UI' ~~,:jvlhrbE(jqn(JAp.p"'ii;:P-:::0~1' """,,-,,",, '''-'''~''''<- '-' -,.._" II' ~ewC"A ter'atlOo OD xtenSlOn er ane," ca Ing tl,A _ . '- 1-''';:;;:' UI InP rfl' C nUmb q~~ qii'Eliitr. (Note: .the :17 'I $ 43.00 erEacht.l\ddJtlQ.ngb~I(9~~~tOF ~lth J. CServiceorFeederPerrnit\ VII,,-,.' $ 3.00 - . vvv~,j0.:::'-2344 " '_'_, ..'_:..~ __,},+,,<, .. ,,,,),,;,.,,,.,.,~'''''''''.'r:o'-:.,,"-''''' .~-:..' ...~- E. ;~.l\:lis~~ilan'e~~~ '(Se~vice/f~~de'~"n~t i'riclu~ied)';Ea~h iri~tall~tion' ; ':".;.... "-'.'_' - _ ..:..,.I.. '-, -.:-, '. '~'_' '. ,,.:;;,-~,.~ _ .,..... -'.. .....;.'.-4- ~._i .~, .~_ ..'._~ ~.. ..._. ,,,"l Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25,00 X $45.00 A< .00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ;;l'~":';""" "'''''~ <,<"'~,'r.',,- 4",SUBTQTAL.O.f~OYE >< l' .'_, .~,', ., t-," ~; ;::'. . '" ,',~",,"',. ,., 1_ 46.00 ?\l7 4- .r?O ~.VJt; 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnsJElectrical Pemlit Application 1-03.doc