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HomeMy WebLinkAboutPermit Electrical 2006-5-18 CC/ ~~.~ l~~~~il .~...~ ~-""!'j .~.."'.. ,:0; .I';,'~ ," '. .s5 ' '. ~b... ' :<.: :'~.. '~'''''' --.-.... ,< k If' ~ .'4,'- . 7"'.,-''t.j "~.""~. .~...'.n..',j-. L 'f" _", . , " ,'" ~ ~ f . ,. , ' ~./ .:.. - .:. -:, "qIEfY(pE:~,. :,,~~Ii " , qmi?ll~::,;;:' ""'-~:: ,..1, .', 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CoM z.o6'-. . 00 572. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to,IOOO!Afups /..{i'il L{~r8C]On b\\~/n\,ot)lx;;,~sivoiiS . '\ ' thP. VI 1:;.0'-1"" -i' rth . ' a(ICp\~:J Recorinect OnlY5et 10 " . . rL1\e::> (.I.'''' , :.. r(;nter. fliose . 0^P q<;2-00'\- /6 2 ~() -f -:'~rJ .~ln1 ~oo1~.t'~~~~oi~w~~~Yl~~~!9~~'rs~-.~;t t~)'~;:' ~, \I'r~~' ~- U may obtain. u\-'~~ tnetelephone / /) I, 106 . 0..1" J. 0 ,hI' center. Irt'St~lliltion;:AlteratiOii10r Relocation fulJ/1 ..--~ . Ul\I"1"~'" "~m"'b"e~r lor the ore26'Q1 Amps;.oJ'I~s J nu . "\ ~\ l\)~';)V~ Constr. Contr. Number i. I '3 J ') "enter IS - 20 1 Amps to 400 Amps a,,1 f 401 Amps t~ 600 Amps Expiration Date V f.( OK . . . Over 600 Amps or 1000 Volts see "B" above. D ~-B";tA-:tlh.)C'_~:'~''ll~~~ ''''~ :7~~f'~I,;-tT'd1~'~"'\",;i\ ,/'t " ~_1t \"~.',., ',~:., 'l:~l Signature of Supervising Electrician . ,l~ _r~,'!l'~'f,,-)r.~~t ~:J"'e{,:,~YljrJltl.,~4.:~,:" -:*':,l.:". 'l~:<>-I);".t ~~J J~) V . I Owners Name ~ StN'Ao;.c;Mr- Address sZ7b IAW~""",+ ~I\. City l:;-U &fflc Phone 6Db ;f:/ID 1. 1"LOCATfoN.6F.msTA.f.I::A116N:;:;#t;~''i~Jj Lj -7 ( . --, "s n_.. Irsf" - < -".'j LEGAL DESCRIPTION 1"7031. S3 ( J '3 'J6C JOB DESCRIPTION Sf 6-;1/ U 6rtl-n IV"G- Permits are non-transferable and expire if work is ;, not started within 180 days of issuance or if work is Suspended for 180 days. 2, l~q;,iNi!Wgto~;w~i~~;Qi;{N:Q~i~~ l MiIt!.,[ Ki: t-I1 <> (t..; > <qvu.........~ Electrical Contractor Address 7-<.0 S'f': City 6J1..~ Phone Supervisor License Number Expiration Date f I OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~/;~6 3. [Z'C9M~t.,E:rn\1fff~'-i5,ilELJ}i)tE'B..IIj};(il~{::t:k,-,;~!ti~{""t.f,.? ,~) r:;l Date ~;j.':;i:2f:~';I~~~1;"i","",,~~'~,'f;;-17:'''~'':j~i:'if,'7"''"'.7~'l~'';f1.'''~;;f'''''':'~~'7~."", A. ~N.~JXg~si!lenl!~[';;:S.i1igle;,~rl\:!!!.!ti:f,a !,11Jlyr~e'i~jy~It!!!g;~!,i!:,d ~ ...... ."'_....,_.....~l" ~ '. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. ~Set~~i~~;~'~tEe~~-;~..~~Irt~talli~.ti~li" Al-t~ra'tii)'h; hrTR'el~~a~ti~n:'~:~t,1 t:;{"""''' i''C'''ll...,' ," ,,~'~' "-,,,j::ukiDr :'}'''''':<''V.';:~'H'lj';'''W,' ';:'~"!..""J'-' .'1''''" ,;--,'~y.). ,',,-..' ,,~.'II-' ',; bJ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ."'''.'' .! ~'~""I~ $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 . ,,,. ," ,.-"", ,'_, _,;-.,., """", ",,,,~,,,~,, .1l"'mL.. w"""-' ~_~.. "",'"'' ",,-,', E. [;! MiSctriiail~ous;(S.el(r,\i~e/fe~di~, n~f .bi~rU~e~~Eath' ih-sitma ffim :1 ~omoc:'"'="'''xP;Rf\i:"(t'it:'W ..' '" .,. w " \ItWePrO!liITigIti~~I\LL \\-\lS'PEP~m IS N$l50.00 Sj~lout1iiie.ilig' itti~g~R. ^NDO"~{'\ fOR $ 50.00 "J'l~,v'''- Ie; All" L- &\91!w!\Pne[g9~~d'mtial $ 25.00 ..' . ""Eo "^V/",~P.IOU.. 1 $4500 .cllDlteu~ nergy ~ommerCla . .".. ...J'C:::> Minimum El~ctric Permit Inspection Fee is $45.00 + Surcharges I ;<J.<:,t" '-.',,, . ~ ..,:'<; J -;~.r ;" .....'..;. "'., ':'!;:;--!<'.I~fibc:.,J~~~.> "':'P' ~l 4 r..S"D"'OT....r'.OF'-' DOVE-n"""'.", ',' ;.',f 'I,,, . . ,,(;)>>.1',' .r1.JJ "n>> . ,." ,.!.' ", ',"" e'", ' ~, ','::. h<W'J.:,U'{;."" -.h';,:-,,~l~, "",,, ~':I ,..k"'Lfl, 1;, -.: !/.i'I~f :,;,~.!", ,-41. , ~ '\'" .",....."-"- V'~. ",", . "~~",i ,... .. .'....' so L/ C) S-'j- 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)lBuilding FonnslElectrical Pennit Application 1-03.doc