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HomeMy WebLinkAboutPermit Electrical 2004-6-25 ..' ': -1-' .': CITY OF si ~jNGFIELD, OREGON ' ,-'I. '. , .' ; " . 'I.. 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (5~a.~~lroiect as sub'miNed~',th . a Des not req . . _. 'f e tOJ/owing ELECTRICAL PERMIT APPLICATION PprOval. U1re sp'e1ti3 land USe City Job Number Cowz.oOLi -DO 67 '7 Date ZOning 1!.Ji. Date 1_ "H ". rp-dS--Oif: \, . 3. ,_COMJ>.LE~!! FEE.S~~#afuf.OW 9( '<L 1. LO~FO~ 0]' IN8,TALIATION 'gKl.(. >. ),- S~- LEG& DESCRIPTION /703:> >'( z. L ,\-(,A \' -'~'fJ-4 D9(OO JOB DESCRIPTION \ v"'>.k l. L 1..Jlh..-,.. lcC,^\tJ'\ Sq,,- 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. r""'~_ - --;;~_"~~'~"--:-;- ~ ...~-:"'''f'.- ;'~.-:-'r-~ ' "';:' -'-~-7" CONTRACTOR INSTALEATION ONLY' ..:.,..___..:...._-- "..t~_ ...:.._~_.~,__:_. __~ :..o<__...:~ ~ ' - Electrical Contractor \.-G><'W' s:. <" """ li-.." C zl Address ~ D -:l-- h t::., U,-"",/ ':l.L-{ / Phone Ffi \ -9"21(- I;,?GZ City AL \r.,p, "'-,/ / Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date \..\ - Signature of Supervising Electrician --Jaffq;-/~~ Owners Name +-\-.A \... L:::-::, 1'1/ <> k... pc) r;,,7" '6'8' Address City spe.) Phone OVVNERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 @~ 'SPAINGF!E!....:;:) . -.~ .. A. ..;N~w Res,idential7:Si!lgle or Mul~i-Family per dwelling unit. -....,...... ,-' ,'''- ,.'. .',,_. .-' ,. -... '- Service Included 1000 sq. ft. orless Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 ~,-.':\.-:.-':7flr:'<~'"7.......];;,;;:,p~J~:~~r'{:<;""'-"r.~."':;:;:':~';.' . ',"'-." - ......,-. r -.--:--' ....., B. 'Services,or Feeders::' Installation, Alterations or Relocation: ....-.....:..._'!.::'-~:..t-~'-~J;2L.dZ.,..~'nl:--=-';:..l._ _,:", .c. ._ __ ~',. _ '_i 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolls Reconnect Only New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit- TOTAL $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ..-._---~-~. . .' "~. "<'.' .' 1,23 >f ~ f~~'\;l~f{~~~~~i~':[r'~~~~.;~' \ O~~~~IOp.~\1 S\1t>,I.~ 1\11~ftiRMib\.~~~eration or Relocation \~~r\O?l\lCO \lI'lO~S t>,B~l)fA~Qor9r.s \ Y. L.\ ~1'-~t-,\(',t.O Q\\ \QO 201 Amps to 400 Amps \.I~~'\8\) OP-'i \'t?l . 401 Amps to 600 Amps o f{: r>: Over 600 Amps or 1000 Volls see "B" above, :'~--,~-:. ",'-;' ,. >,:...:" r".:;"_.'~--" ".' D. '~~~'~~~c;~..~~~~ti~~- ,_~: _ ~.' - ".~: _:_'. ... ;::-';~",'''''''''~r--:-'''n'''.''';";';,~': ,_~'_,...'n'__" --. _". .-. ,~-_. -: E';~~W'/YON?,~_~~ilI~ch !nstalIation; ~lollow.rules adopted by the Oregon Utility PU1r,9,~~fa'tl9~0~nter. Those rules ~ sbfll:lltl <:>_. _ , SI'1ifO'.ltI!{'95~10throUgb.O Qad~~. -"""' ~ Li~\59lf."fWW.~&ialn coplell of the rfill!!S~1 Limit~1~.,'lfrounteria(Note: the telepllQ!l!110 Minimum BIeffiR@rp,grn\\tEl:Qm9R[;\.lUD~ty<'iW~fi~charges ~ 0-' .. ,""' Center is "~;.800-3~2~). - IV'" 4. s,U11TOTA!Co.F~~?,.':~., :~ ,W 7% State Surcharge ~ - 50 v 10% Administrative Fee ~ 0<;::' $ 50.00 $ 69.00 $100.00 " ' ~ .. $ 43.00 $ 3.00 ,S8 5~ Shared Drivc..iT:)/Building Fonns/Electrical Pennit Application l-03.doc