HomeMy WebLinkAboutPermit Electrical 2008-3-11
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2251'11' Jrl STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number' COvtA 7..608 - 0 0 I 7 0
Lf(J5'-~ 5
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Constr. Contr. Number /7 2. ~.~~
b2&1J 7' Over 600 Amps or 1000 Volts see "B" above.
Siitat?4'~ofSU_Z/'P. erv' . gF:l ,~c' d. D. .'
New Alteration or Extension'Per Panel .J
One Circuit ,,' $ 48.00
II ~/ J fA" . .'- -. // -_ ,'" Each Additional Circuit or with
V V"LL. -,'\ .., / . Service or Feeder Permit
OwnersName: ;Ty~t:N ,t:/VI _
Address : 7b Z L- J 6I1JU dtL:. . (JL - E.
City iij;A~flAi rJ Phon':.Z7K -b 75 } ~~~lM'liiMffi~&,\.L ~~R~J~MIT I!\JilllS 55.00
OWNERINSTALUll0N . . .~~~.~~DDNW fOR, : ~:;~~_P.~__.
-The installation is being made onpropertY rown which- - -- "ANI1iUlfjili~rgt8b~ercial ---- $.50.00
is not intended for sale, lease arrent. Minimum Electric Permit Inspection Fee is $50.00 + Surcharg'es
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Shared Drive(T:)/Building FormsfElecmcal Permit Application I -08,doc
1.
C;75 S- 0 ,3.s I D,A-A/
LEGAL DESCRIPTION:
J8(JZD300 D8'L{Oa
JOB DESCRIPTION:
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
-- ---Suspended..fm:-180-days---- --~--~-
2.
. Electrical Contractor T;,f)/b!cJ, r-Iec
, Address ;;2087'1 ~ (f
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City
.g~/
.l'llone J..., I
"..... .4
3n--r7'O
Supervisor License Number
Expiration Date
Expiration Date
Owners Signature:
Inspection Request: 726-3769
3.
Date
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
Ff':e_der
f $117.00 /17
( $ 21.00 21
$55.00
B.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Uver 100U AmpsN'o![s
Reconnect OnJy
ATTENTION: Ore on I
foll.~"t!' .
Notlf/cati. e se 0
In OAR 9~_~tQ~1-001 0 tnr9Wl!b~~~ ~li
0090.. Ydi/tmtY'8Bfa~ c~ples bnlle ru':s by /.
cal"ng~~r lWbte: the te'ephon~
numbe..- .tbepe[e~t1 Wjty NotificatiOl'
Ci~41Wn~ 1~r2344).
$ 70.00
$ 83.00
$138.00
$180.00
.:i>4D.00
$ 55.00
$ 55.00
$ 76.00
$110.00
ss-
$ 4.00
4.
- 12% State Sur:charge
10% Administrative Fee
5% Technology Fee
TOTAL