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HomeMy WebLinkAboutPermit Electrical 2004-5-7 ..' 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAWERMIT APPLICATIOlJ/ City Job Number (' )::iY't) 1'\1)4' ~ CYJ-.{Q1ile I 1. ~:L'O&110N'OF INSTALUTIONW0;!;1:(;lj ':;"~i,t;_ ~.., . _: _."~~', ~'" " ".. ..,!.. . ...~<i'n.~;.~,...'.,,!.-., Zf;~ 5h4-n... A- & f. LEGAL DE~~T~Ol:\ \ %""YY:J-L JOB DESCRIPTION \'n?ffi -1'" ., .fe. tLt-u..s-I.:. ....)""-1 5, ~ Permits are non-transferable and expire if ,,'ork is not started within 180 days of issuance or if work is Suspended for 180 days. ~};':!,';.;;;7 ,~"".:t',':0:'~~"'J::;~<; .:>",- 1'-, -:;"?"~\'~"'.: '!": ~~::'}l0"" .-'~,";t, -;CONTRACTOR INSTALEATIONONLYii.' 2. ,;<'it;:~.;::ti.i ~~~b\.i.f,,~.{I..'q;j[:fjL::::,d~ ,: S!1'" ,,:.,:u...-,Il~;";'::::"-:::,~i;-,t:~ . ,'I,\) 'ii:;,,,d , ElectricaITC.Qutra;;,tor f~ Jqu!:t.. ,..",.~ ATTEN 'IUN: uregon an r ~ - ) . . 1~~Qlt~~I:t:}Xr1 Q5\1lw 9f~~U ~ tfo1\t\catlo . ~f, In OAR..eS2-001-001 0 tPi~h OA~j~>';. ':;LfPtf" ." 6O~o. 'f~~?IM:lPRh1>1il! t~5'. calling th center. (Note: the telephone v number for the Oregon Utility Notification SupervisoOEiAro~<lS'l\Hll6&3~~:r: ~ Expiration Date / D If), r, , Constr. Contr. Number / 'fs:7~ .S Expiration Date 630 -0'/ I cJJ.. ig lure Ofsuperv1&lJa A_ CA.lI'oN - Owners Namerf\-[r.kaJ ~du>\dCf- Address \~()S P{..r\-:\F) "S\Y'~I Ci~ ct:kne U OVVNERINSTALLATI0N The installation is being made on property I own which is not intended for sale, lease or. rent. Owners Signature: Nk: Inspection Request: 726-3769 ;PR.tN:C.r-IEL..O ~..:-;;.o;:;::l ~;;~{h,,{ ;7'~~\-' "~ hl~~..a;J.'~ ....~b/ () ~~~~~:~~~~~o~e~~~!e'~~:~~~~~j~.~~~~O~~;ine ".", 3. :c:;()lI1PLETE-FEE SCHEDULE BELOH(.~,~;;"):,,.i:t'~~9',:i)".' t<, ,_" "'._' '~T .Zonlng'.-~ ..~.,~...~ ~,,:,;,;,,"~Z'-..~ "".,""': ,\,,,,,.,, ~~~e..",,!, ,. ., ....s:--II-:-cO.~ " .';,,,,,\ A. :;.1' ~~:",Re~id~I~iab,,:<:I{i)!g!;l;dIfaM\lI\i-.Fal'lily pe~d~r.~~!U,c;1 Service Included . FAX: (541)726-3689 .- 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 :":~ ~'Iir:'" '. ';-f..i~'. "', ~!-.'Jj~'.. {; ?;:,N\::;::r '~~.'\~."X1.., ....,..;.<~"l91.r;~'~. ...~~ :P':cl~~~~dt:ft B. ~~ivS~r:~~~,~~ ~~oI~F,e;(',gt;~~~i},~~J~}.I~~~o~~::-:\lt~.~~ ~J~ils ~~~"~c~~,o_c;~~i1~::,ll~ .,"",' "",' ,,\,,-,',..0-' "..,,,,,,.,~4 "'" '-,~'^. M_, ",,,.,,,,~",i_ .c..,~I, I. "-,, ,,' "..., _ -...,w', ~....-. ',,~,_'.. .1"'-,,"" """'PC: ~" 200 Amps or less $ 63.00 20 I Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 60 I Amps to 1000 Amps $163.00 Over 1000 AmpsNollS $375.00 Reconnect Only .., "" \ '.'~'50.00 C FT,~:""",'~j",",~s",;"::.;;jC:.,. ~~~%~;..~~B. ~\f'lI,j~.2"i';"'1:?,>~,.:;:;,P"Wt\{[;:,~ ';~~9>6rb~~oCit.l~'lJi~~~-Sd37.\'il0:::~r'~(:'~}it'$;9~1;'ZIrfl' [nst~SV'l.'1\'l\Iitt\a'1t~1.~ri\eJ~lI6tIJ1N~1 \\.0" 2b~iS~lLd\ j'c\\dY- .'3';) $5000 2~ Amps to 400 Amps $ 69.00 40 I Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. ~~B~6~~~i~i:t.~i~~,i~'L~~f(~1~tq;~,tQ~t~~~?~@~~'~~~~~~~t~~~~ New Alteration or Extension Per Panel nne Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 1(:11 }--1.t:",,'-:c'--' t" ,{/~~!1[)'-: '~~:,: :._: ,fJ~--',:i),'->"':;Y,~._~,"';: '''J~\.''. ':i:;~t~. r"::.i' ~. :-,":'f,~;~ "j-"?}: E. {rp~~~~~_Il~~:~~~(~.e~~i~~~~~~~~er~!!~,tilil~~~~~~?r~~~;~~ ~~~!311a.~Jj.~~J - ' Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 ~()- $ 25.00 $ 45.00 I l\linimum Electric Permit Inspection Fee is $45.00 + Surcharges :;/'Sli-;~ " ."~ .r,!_'., ~~&.-.. --~ ':'p",::" :'.P '}...." ';J;'-::-b.~~ ;._\:;:,'~ .~~.~,::- -I;,: ::-rt~ 4. ;.SUBTOTAL OFABOVE",;;,V.j...'~':";/",,'~",', \i:-:':';:h; ,"'l);;;~~., ;. -,;:.'h < ~~;::i~!.;'(/.:_t! ';:,.'!"-~:~~:';\,::),'i~>i~~;I~!',,:;J-'::,~h'J;"~ ~.. -- 7% State Surcharge 10% Administrative Fee 1.{D S.OO $~~.r~ TOTAL Shared Dlive(T:)/Building Forms/Electrical Permit Application I -03.doc