HomeMy WebLinkAboutPermit Electrical 2007-6-1
09/11/06 MaN
10:50 FAl 5417263689
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CITY OF SPRINGFIELD
Ii9 004
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lNITlALS N fV~
DATE t. .,[, ~-n
SOURCE IY\.~
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m FlFTIl STREET. SPRINGFIELD, OR 97477 0, PH:(541)716-3753 0 FAX: (541)716-36"
ELECTRlCAL PERMIT APPUCA TION
City Job Number en I . ,-::uJ?J7- CJ7),r-;( Date en - r - 0 '/
l.I:,OcAi?fjfi;p'i1I?ist~h4.T!PN.i.':;;:'ii. 3,:/i/f4fPL.f4fpI;iij:;$CTfil!jji;f!,:BiJ+o.~'
NcA:l. '~on...-r.l (Jp,' JJr' ,""".." ",', ,,' " '"
LEGAL DESCRIPTION: J A, ;~eF;~~li~~Y#:~SJNff~~~Mti:it!~~i~~rd.~'~III~~Un1t,
''10 S 'n tJ 0 ~ (0 () () Service Included
JOB DESCRIPTION: 1000 sq,~,;ohl~1rtnl\" Of SI06,OO
-< , n Each additional 500 'q, ft, or egOi I law r eqlJlreS you to
LA ') I>.,-t- (fr...,r- portion iJi1!i~W rules adopted by the Orels:1.9,ootililll
, Notification Center, Those rules are set forth
Each Manufact',d~Home,or () ,
Modu'i'&'OY)[Jllng S.'~lce oP1 0 through OAR qS~.001-
F d' IlJ;;'), You may obtain ---,- - ., 'tS50,00 ,
ee er .--~............. . Ie rUles uy
""", :81:Jtf1qih~,cen!er,,{Nqt.s;',lhEJ,telephnn'"
8, Servl(O$,or"Jlffil.n,",JnstallaUolI; AlleraUOn.ljor Relocolion:
, "',..., ,~"', ''''.' , ~ VI "YUi I lJUlIlY I~Olr Icatlon
200 A I Center is 1800-332 23t..A,L 00
mpsor ess :"b'J.
201 Amps to 400 Amps :$15,00
401 Amp' to 600 Amp, ',S 125,00
601 Amp. to 1000 Amps ,SI6),OO
Over 1000 AmpsIVolts $)7l,00
Reconnect Only S 50,00
I
Permits are DOD-transferable and expire Irwork b
not .tarted within 180 days of IssuaDce or If work Is
Su.pended for 180 da~.,
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CONTRACTOR INSTALLA, 'TION.,()NLY
2,
Electrical ContracaREGON ELECTRIC SERViCe
P.Q, BOX 2237
fuGttic, Uti ~fqUZ
Phone ~~'i..:l, - (b'irl
Address
City
Supervisor Licen,e Number 'J ~=l9-0 ' '\
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Expiration Date /0 - I - ()j
Con'tr, ContT, Number J La I S 1<)(
Expinltion Date q - ~9: - D7
Signature of Supervising Electrician
IL MINfA"" )(t~PLL</
Owners Name ~ ,0 rfJo., f) 0 J
Add~ss ~
City
Phone
OWNER INSTALLATION
The installation i. being made on property I own which
is not intended for sale, lease or rent.
Owners SlgnalU~:
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In.p'.ctioo Rcqii..t: 726-3769
G~RINO"U:a..O .:'
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Iristallatio'n,-AlteratioD or Relocation . . - --.
200 Amps or less S 50,00 '
201 Amps to 400 Amps S 69,00
401 Amp. to 600 Amp. S 100,00
qver 600 Amp' or 1000 Volts ,ee,:,'8.': abov~, ,
D. ':;~"f-~ ~~:W:~f<~,itij~;"i' ::";~;;:;>~;~~\~:~":?.:-:.:~k":;~kri",;'::~};:Ll \,:'~;;
~e"-A:lteration or Extension Per PaDel
i'n~~ilc'GIt-: J S 4),00 1fc3 '1::>
,lihtAlfcITtiOh~r~~~i'J~Lw~~PIRE IF TH' . \
Serv,celor,Roodcr Penntt ,$ ~ ll9R/f
,.~ " Ilm.'LCU UNuER TULS 0 .'
E~;U\li~lret~:~f~';';i(~~I~~i~~{lt~R~9Ji~.tali~do'n
ANy i 80 DAYPER:- . ""''''uli!'.flJ r~JH" "
Pump or irrigation 100, S lO,OO
Sign/Outline Lighting S lO,OO
Limited Energy/Re.idential S 25,00
Limited Energy/Commercial S 45,00
Minimum Electric Permitlnspo:ctlon Fee 13545,00 + Surcha'1:es
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, 4,~;qS;f;p.X/Jif,:O/{?Y!PY1f, ,;:i;" ':q, 4 S, '-<:>
8% State Surcharge I A \-'0
10% Administrative Fee : "4,sc:>
5% Technology Fcc c:S..~
TOTA'L ',' , I I s.s.. as
Shered Drive(T:}'Building FormslElcclrical Per nil Applicltjon 8.Q6,dQC