HomeMy WebLinkAboutPermit Electrical 2006-4-6
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225 J'U' In STREET 0 SPRINGFIELD,OR97477. PH:(541)726-3753 oFAX:(541)726-lrlI'99 ':!t..~~~'DY
ELECTR1CALPERMlTAPPUCATION Dat" '__ _____t, \' ," 0
City Job NumberC,ow\ ZOOb - 00 '3"7 Z Date 1-\-to-.8(o Authorized Signalure
1. I LOCA170N OF INSTALlA170N
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LEGAL DESCRIPTION \ ..
17D3'3.5:> .1"1'1~
JOB DESCRIPTION
3. I COMPLETE FEE SCHEDULE BELOW
A. I New Residential- Single or Multi-Family per dwelUng unit.
.~
Mr\ Oc.\.l,.k ~ ~~kvd L,~~,~
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. A TTENJeeder
rtn~/. n.._
2. I CONTRACTOR INSTALlA170N ONLy':"bOlloW 'B,14'SefVjc~~:'t~~~"-!. iiistl\JlBti09. Alterations or Reloeation:
. tIt/cation t.,;el1te~ Th > - 0, "yon Utility
I_n OAR 95~200)AmIl'S ortl~~se rules are set fnrlf>
O . - "V IImu h 0
VV:;1 . You ,ZOlyAmp.s,to 400 A'lnps AR 952-0U1_
cal/' - - "GUVII"S f th
1119 th401fAm~ to 600 Am~s e rules bv
.~"Jmber to' '~f. "';.' I"VI". Ill" telephone
C 6~1 Airips!!0'/iO.Q9iIW%t f. .
e'(Wetl<106iAInp~2~~4 Ilcatlon
Reconnect Only ).
Service Included
1000 sq. If or less
Each additional 500 sq. ft. or
portion thereof
$106,00
$19.00
$50.00
City _ Eu~ene
Phone
687.5770
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Electrical Contractor
m Electric. Inc.
Address
4685 Isabelle Street
Supervisor License Number 3782-S
c. I Temporary Services or Feeden
Expiration Date 7/1/06
(CCB 104929 3/14/08)
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above,
D. I Branch Circuits
$ 50.00
$ 69.00
$100.00
Expiration Date 10/1/07
Constf. Contr. Number
37587C
Signature\ti2sing Electrician
_ New Alteration or Extension Per Pan.el 0
-' ~ One Circuit \-It WOR\<. I $ 43.00 43.0
/ ~01\C~'. Ea9t\M~i'i()\iAI\Cirltil~b\WY~~OI 3 9 00
. c \ S PERM\seNice'-or Fffi1~ 'l'efMit\ \ c $ 3.00 ,
Owners Name Lp "" 2:>u 'O<J ~f'rt 1\-\\ OR\l,E1/ UNDER I_I ~Ht:f)NI'O rOR
Address y1lo Lo. v-..<=> _ \0{Ov-l? '~~~ME\'-.~tI\)\t1k~~~~u. (Service/feeder not Included) -Each Installation I
, \,j v'-' 0 Oi\'{ \'\:\'\10....
City Ev..oe.Vl-€.. Phone rr(llrrfnJl0.\N'{ ,e Pump or irrigation $50.00
o Sign/Outline Lighting $ 50.00
OWNER INSTALLATION Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
The installation is being made on y.vy...j I own which
is not intended for sale. lease or rent.
Owners Signature:
4.1 SL"~v~ALOFABOVE
&/0 State Surcharge
10% Administrative Fee
Inspc;ctioD Request: 726-3769
TOTAL
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