HomeMy WebLinkAboutPermit Electrical 2008-3-6 (2)
ZON
INITIALS
DATE
SOURCE
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number C- 0 vV\ '2-Q)() '7 - 0 \ '(4,
City 6-~,
cJ Sign/Outline Lighting $ 55.00
OWNER W~f~IO'N3gon law reqouires YOUUt'ltliOty , Limited Ener~!&l!Sidential $ 28,00
II aQp.oted bY,_t~e regon reU 1 Ilia:;
!he in.stalOO1~sr~e~~n,\~.0'!I?oWtUle9>~~btdlDrth Limited Enerffi~~~rt SHAll F~~ ~lXdE WORK
IS not mt~~~~~~bW~5&f OttWrough OAR 952-001- Minimum Electric . f ~~isr$nQ)({08P$APcll~rllQT
In ma obtain copies of the rules by 0 l7DR-a I"\?\
Owners s~lfur~ou Y t r (Note: the telephone 4. 1 'S L /. u v
call1~~_ tr;.:~ ~r~gon Utilitv Notification 12% State SuAh~gt80 i G'r 02j
1'Wffi ....Center is 1-800-332-2344). 10% Administrativ:e Fee (.....<;, c:LIl-
5% Technology Fee "" ~ ~
:;20t.Cf3
1.
'2.745 D ~,
LEGAL DESCRIPTION:
JOB DESCRIPTION:
~'V0
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.
Electrical Contractor L tE E:: tQdr) c
Address 9JB33 ~OAfL>/\c-r(~ led
City ~p~ 16 Phone Cf -33,- 2 SC( 8
\
Supervisor License Number Lit, If - 5
. Expiration Date ! 0 -- I '- 0 g
Constr. Contr. Number \ 0"5 Y '7 S
Expiration Date 33 I ,- DB
Signature of Supervising Electrician
/"7 Q'~ '
~ (r .
(1) ~'.JbuA" l~
Owners Name 101 (J)/) ,k- (;D!.dJx-e..L-
Address -f. o. fzA.)'f.- Lf-o" \ ?-
Phone C1 Sl+,.. fo?::if(
Inspection Request: 726-3769
3/0 /()~
. I
Date
3.
A.
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
i
:;L
$117.00
N7 DO
4-::2, 07J
$ 21.00
$55.00
B.
. 200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 70,00
$ 83.00
$138.00
$180.00
$413.00
$ 55.00
c.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
$ 55.00
$ 76.00
$110.00
D.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
E.
Pump or irrigation
$ 55.00
TOTAL
Shared Drive(T:)/Building FormslElectrical Permit Application I-08.doc