HomeMy WebLinkAboutPermit Electrical 2004-2-24 (3)
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Q bl!,-O.lBct as submitted has the following
'~ not require specific land use
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225 Hun STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAXz~
ELECTRICAL PERMIT APPliCATION approval.
. Zoning
City Job Number OJWt7001../ - 000 I 7 Date () 7.. I '7 0 'f
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ownd.me ~OS2b(z'o lwM L.EfL
Address -c-.. 0 1<c) y 20 E. ~~~1ia'ii-:ii\'itfs~~~-ntcfl;'4io[mclllaid)lE.'jtih'it~~n:i'tro'n;1
+--' r- ~,-"': ~......-_.,~."ot~~J:'~'''''''"t!~'tC''''''''''.'_'-'''''''I''~''''~''''f'i;< -.;.'........-..:...._i..~~~;,~
City S:?RI/I/&+-Itt)~ Phone Pump or irrigation $ 50.00
. Sign/Outline Lighting $ 50.00
OWNER INSTALLATION ~~~I~E~~i'fim:\Rt'rpffirrt~ew'fHE WOnK $ 25.00
!he installation is being made on propeny I own whicjl.UTHORIifi&ifffio~f{~iliSmm IS f\!CT . $ 45.00
IS not mtended for sale, lease or rent COMMEMl\l.\9l!JlAcISi*lVDGml1li0nFee is $45.00 + Surcharges
Owners Signature: ANY 1!!\F~6Jt=~()"VE'~'1:t;,l:~jt;;j.!i1"Ei"'1,.1
. fu~~~~~.:i.:,;:,,~,,~~'F~i;.;;~:,-~~~~~n~~~it1Bi\;~~~;'~~~ S-O
7% State Surcharge ] SO
10% Administrative Fee SU <>
S-t3 S"O
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2027 S. A $+
LEGAL DESCRIPTION
1703~ f-,LfZ 07300
JOB DESCRIPTION
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Permits 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 ;fCWAO/'/S E/~d ..arc: .
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Address .?/75" LA/. .z.. ~ Ave .
City Jl!5'u"'I...",e
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Phone 3'f3-72-'T 7
Supervisor License Number "R S;:z.. 0 - 5
Expiration Date
/0/0<,/
/72-S-Z-
Constr. Contr. Number
Expiration Date a 2.../ 0 S
Signarure of Supervising Electrician
Inspection Request: 726-3769
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A. ~J~~~~~I}.!.!'!t~~i!>gt~;ot;M.t!I,ttF.'!"1.!Wp':~t;!Iw.eU.ing.u,uit,i~
Service Included
I 000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
$ 19.00
Eacb Manufact'd Home or
Modular Dwelling Semce or
Feeder
$50.00
B. iS~~~FF~1f'e~~1ns.'~ta.'~'iiiti~}(ir~jTiifi~tir.'~?'R~m~. '~H6.'~t:i1ha
~vr'{"'~:.'~~.->':~~.l~7'.L)'\1I,.'"_''''''''''''~--_J-'",;'-~'U.I~''''~"''''~~'''\'~
200 Amps or less
201 Amps to 400 Amps
40 t Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/V olts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Installation, Alteration or Relocation
200 Amps or less I $ 50.00 S, 0
201 Amps to 400 Amps - 5 M8.t\9
40t Amos re-PR9~segon law ""::!~~';r HR9.P'G
1-\1 n: . n b tit.. ~._,,_r7
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D. -~~gm;~~~; .~ ~ ;"s.Q f'fi"~~~"'''''~~~t.m
N'b'O~~rftl6tl:'l!\fnl9\jUin ~ePI.',~~ telephone
One e.l!"1i~Uihg the center. tNot~.:""'j "nt~j(!a{l.Q,n
Each Xo;1l . il"Mf.' itlQlrWl1li'n v..,.. . "
serviB!J~rl~~eder;;:"it. 1_~(1n<I::;2-2344)$ 3.00
TOTAL
Shared Drivc(T:.YBuilding Forms/Electrica1 Permit Application 1-03.doc