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HomeMy WebLinkAboutPermit Electrical 2005-6-28 -......'....-.. ning /+F' .--,- / -no\" . 1 )o/26"36Sl)l s;gn"lJ{!pfY.2v:} 225 FIFTH STREET. SPRINGFlliLD, OR 97477 . PII:(541)726-3753 . FAX: . ELECTRICAL PERMIT APPLICATION City Job NU~;:;(]7JS -GO R /7 Date Go, - 4-X" - oS 1. ~~:Q:~L@'M~~ 3, ~~~A,~ _ - ,--' - -- ...... +',--- - -;.,o?/"-': ~-::;-::::-r:"_-;;'..:::;'7j~::;:;-;:'~."';;"'"$.~-'-- "' ! ~.. .. :'bll.l>Jf:! "'lliJ.t'i~"'~ltY.'F:tr:l~'::!:1~.~ LEGAI:.DESCRIPTIOl'{.:" :':~r::;" ;.~.J'i~",:b"}:~'~J~1~1i':'~r,:~:~:'f;~\; ~A.:" . .e m 'l~l:1.~ ':~, 1--; ~(~~~~:t~5~tf>"IDQCf)itil<9Z;~~~1~~~~~~;."- S f'~I'~YJd~i{~~tp~~l-~~'~~'~"{.:<~::~~'r. .~~.~,," ..'~ -~'-- -.. ~:- ...~ ". '. ; _~"-k"'_"!::-'"t ..._,.-~!',.~_,,:..,~,"~'.~'.__e:~1~~~1!-5~.,e~ ::,.~.'.-'.1;:t.::...." '"i"',,:_.~t...,...., "~.p. ..... JOB DESCRIPTION 1000 sq. ft, orless $ I 06.00 Each additional 500 sq. ft. or uJU,-,,- ",<" r....-a....... bo())-r-L portion thereof Permits are non-transferaJle and expire if work is Each Manufact'd Horne or not started within 180 days of issuance or if work is Modular'Pv'i7F!}jP~1Y6!f-~rS! JalUS~ $50.00 Suspended for 180 days. Fe~d~:lIPION "limn u05eJO S41 JOI Jel.jWllII J t:l"_".,',c:,,,:,,.,,"" ' ,,_.,.' B.~~~" .~'t"Vii~c~i~f~__ .. ~~ -- --,-~ I,",,"",~-~-"""''''''~''-'' - - - ",' < ""'"It I'" .......:.. ~,V\:1v Electrical Contractor QBFGON EI FCT~IC SEQI/ICE 200.p.r;.{jp'sI'o'w,/pnOJ41 O~?o-~Oo-~96 WQ,%OO P.O BOX 2237 . 20i W&~~'fos4tJ5'~Bs41 JelUs;.) UU~O"'!j!l:~5.00 Address . , 4o~ilG:1 uo5aJ~0'lJJ1il~ pSldope ~Ol". ....)11 125 00 EUGENE, OR 974QZ 01 n~~M?nDeJ Mil\' U05SJO :NOllr~3.u: . 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 ..," ~ tt) - 7% State Surcharge ' . ...~xy\\9\' 10% Administrative Fee ~~ NJTOTAL ~ ~ r-v Cfo 'J - Shared Drive(T:)IBuiJding FormslElectrical Permit Application I -03.doc " City Phone ~4.3-( lo'i<'l Superviso~ License loIumber _' / ~~Cf,.:).s Expiration Date J 0 - 0 f - OJ Conslr. Contr. Number . ~o Y to G Expiration Date J n - rJ I - oS Signarure of Supervising Electrician zI~C) fflllA/ , m~rz.~ Ikcduc.t. LIP. Owners Name '1 , l:..') /X'>rt Addres~~? /J7~.u I <' (IAn- h j ~Lu.tdJYL5 h~ IPhone~"l qqgo (scjJl-l8'"1f - <1&~1 IIR'A...?/ lYC OWNER INST ALL..ffi6rf - 0'..:;> 0-"":> The installation is being made on property I own which is not intended for sale, lease or rent. Ov-mers Signature: Inspection Request: 726-3769 ie.. $ 19.00 New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with I Service or Feeder Permit $ 43.0U 1.../-3 <>V ~"'-o $ 3.00 E. "'~~~~1ilifillgil1 Pump or irrigation Sign/Outline Lighting Limited EnergyfResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. 4& OV ~~ 4- c.,u S~. 8'~