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Permit Electrical 2005-11-15 (5)
H.T. ';PR'NJ/flsltE? 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 :~~f~0~'I:O'D..i/ ~~~o:~::~ax;~~L~~~~~N Date lllt r=};~,i~~i ^"(( 1. i~o.s1T!~~RF I!j~,~AL0;lJO!y' ,~.L, ," ' ,:2 f) 2 7- S'/9t>.f.I, A , f'/-. LEGAL DESCRIPTION ~ N '\ \ l)_[)"~fL mDUJ JOB DESCRIPTION SeLu-r-~k --' .~7)("/l U.r ~;Iorrrv, Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. , '- . . "II '. -- . . -'-00 '.- '''0_ ...+ - ~" - '<'"';, '__ ''''~' _,~ , CPNI:RAqOR. INST4LifI.110iv ONLY.' 2. _'. "...__;1.7"".'~ .,.;. .-'_""':.._.~..l. _,_:..::.:.... .'. ,;.~.l.-:::......-.:.I..;.; "~,~ Electrical Contractor '<::::;~L.(lYe Iec...,^ I,-rL_ Address SI (/ I'Ve; 1~~J'ool i ffr- E I LJcl City E u<Z,pi'\R..... Phone . <:;2./. 2g3 T v Supervisor License Number ~=?<, X';) i. t;A: Expiration Date / () - 1- 2cx::J9 Constr, Contr. Number / L.,~/f< Expiration Date y- $5"- 2. OC i- Signature of Supervising Electrician ~/2~, / Owners Name .:z,r:;~//JNI./,pr. Address PO. ~ 2D CitY~Yi~ Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 3. .. COMPLE1-1iFEESCHEDULEBiio'w:7:'~- ',~, "'~ ~~. ~._,,,,._.,",,' ~~. H.... ~~~;\~, '__~,,,., '~~," "'_," ""--~~"";o-Jll'" ""''''~,'_~ -, """}"""'~'L~- "_:':'>~_<W'},<;'-'>_~'l"__.' A, 'i,,':~~~';<,~ir~,~11~~~}.~,~~~\;~l~~!~ ~,[~~~~}!i)~~T}~t:'~1_~~~~I~~~'F~~~i.!.:J':~ Service Included 1000 sq. ft. or less $106.00 N f1"t:~ additional 500 sq. ft. or HfJUG&ereof $ 19.00 h~SJtr::::iP1,pJRE IF THE Wnn..$50.00 MMfrNCED 0 THIS PERM/ 'fll1\. A~: .~ePr\Q~Yi#~~'1a..Af1,Rg~fJS'~Rr~~~~~"~'~!~~at;o'~:"'~ _..:-'::'::-....~...~ -0:......_, U. Q, ':;Hl.t-":':' ~...,;.J....;;..._ t\';~:.:. _ _.to,.'.~.' .~..:.. >... '.,_.' ~_. 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 $ 63,00 $ 75,00 $125,00 $163.00 $375.00 $ 50.00 i:f ,,~,W-J'l~:'\,'! n4..,t~, 1~:l':::_,""'!~._ ,r;:r ";~;':l!' ~~' ',v::y;' ',>:',',:',wc;;:;" ~\Wtt:<,.~'1!' >'1'~~~1::'"\.:n::----S:""-1 . C. f,T~f.1)p'~rary'SerXJ(~~s.'9r,Fe~dcrs",n;:';",!:-;1).: :.'.t,~~'.;(~, ',.c,'};t:,':: ".f ''''~ ..... ".1.,_ . " "__'''_' ,~,'__..~, ,,~,.j,,;;>' .I'~"'".......\t,i....<~_,~ -'<,........ ~_~_, -, '",",,---';""-~ .~~ Installation, Alteration or Relocation 200 Amps or less $ 50.00 A TTE~<t\O 61S,P;-,t: 46000 ,~mps $$ 69.0000 fOllow 4 II A:mps.tu' 0 A:mpsrequireS 100. ru efi adopted h .. J vu LU "Jotificat,Q,ver600 A:mps or ~i OOO'Volts~see"'.Bthabove. . ',..v.puler Ih"".s'.--"J""'t. ,,;'C "l~,.:"" -.... '..' -..~~._.., In OAFD)5tB'ranc.h Cir.cujts.prv~r:@'&/'Q:s~;~~ih:,,',:~~:'~:'"'J:J-.,. ~~~;-.;'->:- ',~ "'.': \ 0090 Yo';~;;Y.v, .~~'trJraD?1n (1A8";;;;;:,'nr I -- ,~-'"'~,_. -_. . II" New'Alteration o[)Extension Per Panel.- ca Ing tl,A -....~,j. ...... ",nc;:-, UI In9 "II C \' $ 43.00 One GlfCUltr. (Note' Ih . , numberEn'htAdd"' Ie. 't e ,Po Ii "" ac _ ItIo.nJ-tJ,',I[5H},I?/ t\~ltt <Service or FeeCler Permit I",~ 11,,-- $ 3.00 .- . uvv~.j,j;::~(::04.~ ,:':'-', ..,,-,.~' ""'..;'; ~,;]",::",,_,..' ""'):'-""'~ ',,;n;-\~j-...,..,.:;"';-,";:. --;'.'_;~~;'" _' ..,;'".. E.;~lifc!lIaneo.o.s(Seryice!,fee!lei not j,~,c1o.ded),;-J;;a~h ,frisiallalion.' .'w,..."...........r .... _._...'_o<;~.',._ ...~_."'.!::.~,._. ".~..........' '-. ~..~ ".~ Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 X $45,00 .4:<'.OD Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ,:', :.:i-, ;:_" '::" .,'1",:;;'- '~:; " :'<:> ~"':Y";;:".l;: :;:;;:[1,- 4. .j SUBTOTAL. OFABOVE:, '.,! ,,~ ",,::, .: .... ....:If: ~,; ....,;,:'. ".: , 46.00 ~.\l; 4-.t;D BJ..VJ~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-D3.doc