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HomeMy WebLinkAboutPermit Electrical 2004-2-24 (2) :.' . - CITY OF SPRmGFJELD, OREGON, . \..~" . ' ' , 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~alil\W~liI/&t as submitted has thetollowing ELECTRICAL PERMIT APPLICATION zOning, and does not require specific land use ~ ,..., L" 0 /1- approval. r.-- City Job Number ('ON\. 'Z.CO q-~OCO n Date 0 L - '"" - '-\ Zoning I A....{j.. 2--2.~--ofr c::KvJl Installation, Alteration or Relocation 200 Amps or less "",0..\ $ 50.00 201 Amps to 400 Amps e'i> ....", \'$>':~\$ 69.00 401 Amps to 600 Amps o.-:"~ C}o'-' c..e'\.' 1"%'100.00 ,,0 r'I,0- <'" ~v \, Over 600 Amps or 100~.>Vol\!i'see~B"Al60v~0'" ~. ~ >is' ~'" ~', ~v D. . Branch Circuit~O 'Q'\ e' ~O >is'0 ~o '0<:- .0'''' .p,C ~O'!i ,,($ 0' "Io.e~. c,V" New Alteref!'m",!!"Exti:nsi~er<l'anel9' o~" . -<'I: . ~v e" C~ o~' >is'v ~ ' One <;ifl;,Ulte", . (\~ R)" c;~. ,,-,\ . ~4,.00 Eaclh:kd"il;bOll!J~ircSit or~\Sjthl..O . ,~,. '1:::r q "''-' \)., ,,,," ~, \,. .~_ " v.."", $' () L SerW'Il'"'or'Feenf.i>erniit 0" ~o<:- Ar'l ,.00 - v/Vo..,?,@fZ ,0'~"c,">l>-9><;j ~~''v0<:-~0,e (l"~ . Address,.:;zStH MA-. ,,) C:::.-- E. l\~c.!if~.w~~~@Xi~.gfe.eder not included) -Each Installation <:-!:lC!) . ~,,,, ,,0 r,r' City <;;;;{Z'IVbFt~ Phone 740-9,l.(/f PumpJirrfg~~0 (" $50.00 , ~ SignJOutline{f:'ghting $ 50.00 OWNER INSTALLATION Limited Energy/Residential $ 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 l01g ~ ~ r ~g 121, 0'-' Owners Si nature: 111\ 4. I' SUBTOTAL OF ABOVE 153- FES 1 9 2004 70' S S I /07_' /0 tate ure 1arge 10% Administrative Fee /.c;.3~ "'. "TOTAL /7Q;::.L 1. LOCATION OF INSTALLATION ~o:J..7 50. J) <;;r LEGAL DESCRJPTlON /7D3 3(" " .:2.07306 JOB DESCRJPTlON /?~{ LF: ;:{UILIJ/tJtCr 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor 1f?:"'.17ok/J C/t"'c/ J#(C, v Address ,,9;7> h'/ ~ ~ City k71M' Phone 3<1-3-72-'17 SupeIVisor License Number cfl6 P. 0 r-~. ~- ~, J 0 J 0 '-I'\~\ f.> ~ / ~" ~',,<~' _~~ o<!S.',~ Constr. ContI. Number A..y ~~ ~'v "- ')'<" 'S!o'J- Expiration Date ," ~ s~~'5:! ~ N'\,- ~" ',)'"~ V ~, S. ~~ ..~ (>,~-~ 19nature U2~Si rK:l't,'l' .b . r. ~'X ~' '", \)\'-~ \..i - 4s.,..":-.--o~u Expiration Date -- '\0~t-;~ 1, I. Inspection Request: 726-3769 3. COMPLETE F~~l.-nLu,-,U DLL0 .," AuthoriZed Signature A. . New Residential- Single or l\'lulti-Family per dwelling unit. . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling SeIVice or Feeder $106.00 $ 19.00 $50.00 B. Services or Feeders:- Jnsta,Bation, Altera~~ons or Relocation: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only / 3 Du $ 63.00 0.- $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. Temporary Services or Feeders Share-d Drivc(T:)IBuilding Fonns/Electrical PL'nnit Application I-03.doc