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
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;:{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
~' '", \)\'-~
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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