HomeMy WebLinkAboutPermit Electrical 2005-6-17 (3)
225 FIFTH STREET. SPRINGFIEZD; OR 97477 . PH:(541)726-3753 . FAX: (54';-~-'{;89
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ELECTRICAL PERMIT APPLICATION ,\c~'~q,.'I>:"q,
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LEGAL DESCRIPTION
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JOB DESCRIPTION
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Perm its 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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Electrical Contractor 'qa (/ ) /14 .f./IIJ.tP:tu .d.-
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Supervisor License Number ~ 3d J?;;; 5
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Expiration Date
Constr. Contr. Number :S / () J'R
Expiration Date ~ -,:} 7 -Q,c:,
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Owners Name
City
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Phone
Address
OWNER INST ALLA nON
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion Ihereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50.00
B. ~S-:r~tci;:h~~F~~d~~~~.fh~&Ii~iii)ri~~A1\I~f:fi~~6~\Rtl~;~~ti~~-::~~
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200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
I $ 63.00
$ 75.00
$125.00
$]63.00
$375.00
$ 50.00
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C, Temv.or""", l=rWces;o.rWilliilets:;;:'!(;~"'~~iresynW~:':"-' ! ~~'.11.
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follow rules ad<Wted by the Oregon Utility
Installat\%tlM!~flb~oel!Ii~f.l"l'~Hg~ rules are set forth
200 Amp~'p()IA~ 952-001-0010 through O~R~!l~-nn1.
201 Amp(J~O(wmay obtain eo Dies of the9r.Ollls bv
40 I Amps t<e~~rtiJI& center. (Note: the toli~e
Over 600 A'i\\jWlWlollb lQ51Q~~,gClfr4Y~tyeNotification
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New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
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E. \';MisceUail€oilS'(Service/feedef,'nof,iircllideil)'::"Each~liistaUn tioWl
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Pump or inigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00
The installation is being made on property I own which
is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
N aT ICE . rEi:.,""'~:';;>.1~~v'!:;;~:S'i'.1f~~".~'~~:t~~kl;",,:,,'t.;;;:;':%':$;i}"~;'-.t."I:'~f.'!-{? .;;.z',~!' " "3
Owners Signature' I. 4.. csvnroTA:l):OR!A:BOJ!E:~'='1;r;"].~~~;/~t:J!:~'6-':.<t;f\i;
. . THIS PERMIT SHALL EXPIRE It- i~.ll\V&l~~~.lli:::;~;i;~"h>""';,,j'f!!~\f#~
AUTHORIZED UNDER THIS PERM7%l~t~IPSurcharge Lj Iff
COMMENCCU UK I::' ABANDONEqt.9,~dministrative Fee b 30
ANY 180 DAY PERIOD. 77 -, r
Inspection Request: 726-3769 SC rrwAL ~
ANN t U Shared Drive(T: )/Building FormslElectrical Permit Application }.03 .doc