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HomeMy WebLinkAboutPermit Electrical 2004-2-24 (5) . 225 ;llln STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAXi:M ELECTRICAL PERMIT APPUCATION approval. . Zoning Cl!yJobNumber (biM'200q-OOO 17 Date 0"'2. I '7 0 'f 1. i~!:Q~~t19~ljff~.v~.1?~ 20'2-7 s. A st LEGAL DESCRIPTION /703 <:. (.,LfZ 07 3DO JOB DESCRIPTION TCW' f' ?Ow'c-<L- Permits are non-transferable and expire if work is not sCarted within 180 days or issuance or if work is Suspended for 180 days. .~ro!ifilXc'.:~7{JW1N'SFAiIfj;fTioiliJNt" ,. 2. CJ~.,_~''''" .~-,."........ ) ',\y,,"a;. "". Electrical Contractor Jf~HoldS ElI!."d. ..t3rc. Address .2/ 7~ LA/. 2... ~ five . City E","I el'! e if Phone 3'13-72-'17 Supervisor License Number p( 5';z.. (') - 5 Expiration Date /0/0<'/ I' /7 z..-S- Z- f!:)2.'/ t::)~ f Signacure of Supervising Electrician Constr. Contr. Number Expiration. Date LJate 3. ftOM:P.t.:ETE$~&. ~'''''-"'''''''-''~'''~- ~",,~~"'.-;'r ",~.?'--=;""'-::'r-"--"'~s.~--r..;,<;;j:'JJ:,....~....~"...".,.--";'j:,?-;:;"":'(,;""'~""''''''''.':;'.7" ''''-,,;~;o:..,J'<''':; ;a.,;;;;:S A. ~,~':\':'R.~si~~!U!'!t~,~i!igl~10.:,NYI.tf.F:~y~:p~t~~~~~i!,.g.~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106,00 $ 19.00 Each Manufacl'd Home or Modular Dwelling Service or Feeder $50.00 B. \i\s~~<iW"."'::R. ..~."~~~!iltIDilli'1'i~""\iXfr&16~,<;\:rim6~Wo'i\.r'ii";J;! ~"':~"''':':''::'':"'tJt;~~'':".:t;:!,*~::Q.').q;_'''''''''''2.\'''f-""'",-''[l'~~~~.,~~ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. ~1"iD:1POr'i(~~~:or:;fe'e(fer~'~!\ty.fJ1P Installation, Alteration or Relocation 200 Amps or less I $ 50.00 So 0 201 Amps to 400 Amps .-5 ~&2.t\9 401 Amnsf~M'~"""segon laW ''''''IU''- t,1I11Hlll AI rtO;;r';<::~ 'e<1bvtll..~.':;il")rrt"'''''ll Ov~(\Q.Ot.A:nips!QflluuO'Vol~.$.e.." 'l[l!p,oyes set tq,rt 'D ~1J~~_"'~- '",,: ~ - >'t:<.:~'<;:<.l;.{ . -.'~"- - ,'lfIo~"1f~~1f.~.";'+~~ . ~_.,,#~~~, ."...'. ,.- " ' .;." ,.."-. .~~~;~~~~~ \ O!llH \:10 - '''P~S () tne Neoo.M~rf8B"1l!ifuer\sUin ~e ~,~~ telephOne One ef!li~ihg the center. (Not~.:..,~. ~lgt~i~at\llJn Each XClo' ',,".1.G" ittOl\w,.1Jiln u,,,,t, ' . serviP~Jb'rl~~~'::'i~ 1_fl(\n_?:~2-2344)$ 3.00 Q~44b-.-/-::5 own~e ~OSR:J(l.O lwM k,Rt. Address ---.. 0 150.. 20 E. ~Mh~'ill:ililli\';li(S~~~f~tdr.'\'fiijtiri~a:d}ffi~h'iiiHfjit;tm~,1 +-", 1ib>:;:~'A J";"'''''''I~'"'''''''l~~'''~'f:f1~l~~~'-~'''''''lotOO.'''''''''",,,"';'' '::l;I-."~...".,,.,.-i..~~~;.I.~ City S:?f<t "'6+1 a"U Phone Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 OWNER INSTALLATION ~~~I;:~~i'f~~ANerpffi~@"fj!i'!\lE WORK $ 25.00 :ne in.slallation is being made on property I own whicl\UTHORlfEitYiffflom~'n~rJtIIr IS N~T . $ 45.00 IS not IIltended for sale, lease or renL COM\\1l!liroEI9 &PfISi*lVDlJm!i'fiemFee is $45.00 + Surcharges Owners Signature: Inspection Request: 726-3769 ANY 1.!!lF,~OFABO@t~'ti.1i1~;':E\J.ii1Jfai1 . h~~.iZ.~~~:J.:c.;-'~""~+'':'i:Y:~''i:-'1.:,:.~.~if:1];~1~~~:~~~~?~~ s-o ]SO 500 5""8 s<:> 7% Slate Surcharge 10% Administrative Fee TOTAL Shared Drive(T:YBuilding FormslElectricaJ Permit Application l-03.doc