HomeMy WebLinkAboutPermit Electrical 2008-3-25
SPRINGFIELD ~,..-.~
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INITIALS
DATE
SOURCE
225 FIFlH STREET. SPRINGFIELD, OR 97477 . PH:(541}726-3753 · FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
CIty Job Number CP&N\ ~oO 8 - C' 0 "ZL\ , Date
1. "L'OC4.TiixivoF!J:vSi4LLATIOI'i/},""", 3. <COiIPLETEFEE'SCiiED'uiEBELOi,y~", '" :.<,.,: - :,':' .'
'577''; ''''''C:A;;;:;;}7FA .""~ s.f-' !I!... ..." M'_H'__~';'_-" '......... p' - "_,'~n..._ '~"'_"'(_"_"-,.,-,;;"',,,
o ( 20 tf
LEGAL DESCRIPTION
J70 Z '3 '3 4Lf
JOB DESCRlPYON
Add/A~TtYl. f c,rc,^~+
Permits Ie non-transfer:ble and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
_ .,._~' ~~ .^..~ I ,. J"'l-:l :;'~"'_I"""r\"-!.-""-:: -I' ,-~ ,.
A. " fIf ew Residcntial- Single or l\'lulti-Family per dwelliu" 'unit. '
~.'-'_"'~'h";' ~ ~_> __ _. ~ N -' n-'!"" _.\.Y". ~."'~~,~ _ "t_-I___""'>-"IV~ ~...>".n"v
Service Included
1000 sq. ft. or less
Each additIonal 500 sq ft. or
portIon thereof
Each Manufact'd Home or
Modular Dwellmg ServIce or
Feeder
$106 00
$ 19.00
$50.00
'~....~~ ~~~, N~ ,/< ........." ~ / N .,.' ~,-J:y~"" '\ ' ,
2. ~C!N1,]!:4,C~?!!.'I1'f~T~~~~?!! ~~~. ..rnO"'~OJ~~~I-~~i~~~~ti~~, ~ltera~~_~ns. o~.~el.oc~.~i~?: "
ATTE'''''' I.... db the Oregon .u, "J
Electrical Contractor fh " I,.- t-+~ r::tP -:j:"\-lt; fnlloW r~'es adRfat~~ ~~s are set fOr\~ $ 63 00
NotificatIon ce~~~o.m~52-00bY $ 75.00
Address :0 i-f' ~~~ ILL i'" ~ ~~~~~i~G:~~~~~~~'~~e $12500
o caliing the coo~~11i~d0~~~wthcat\On $16300
CIty $~ Phone 54 r ~z (- S~limber for t~~{~~fi). $375 00
Cent~e~o~ect Only $ 50 00
Supervisor License Number
LIII ~ 5
ExprratIon Date )0 .... l---V "I
Constr Contr Number 14(, 74,,'
ExpIration Date
1- 1'i(-~.1
Signature of supervIsm~;:~~:~eJan
/;;/~-~/~~ Uq
- ?r - - -~.
o(:~rs Name /1)LM.' G {", stJ.Iol J
Address 5 i 7 r C~IIV\ ~//'A
CIty S?F~ Phone 7'11- 3<;'bl
OWNER L"I/STALLATION
The mstallatlOn IS beIng made on property I own whIch
IS not mtended for sale, lease or rent.
Owners Signature
InspectIOn Request: 726-3769
c. " Temporary S~ryices or F~ede~s
,..<.J,~_",_ ~~ __ N ~ _~ -
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts .see "B" above
D. Branch Circuits
$ 50 00
$ 69 00
$100 00
.. _ ~ ~ _ ~ ~ . ~ ~ > A ~ _ ~{ --
New Alteration or Extension Per Panel
One CrrCUIt I $ 43.00
-----~~tlOnal CirCUIt or WIthE W i\-\E W~RK
0414lO~iF~tWfMo\JtEX\'\R ..... o'rOO
\;) t"t:nl\ll1T UNDER 1H\S PERl'Jllf \"
E.A~id1Pr~Lli~s.-tPr\~i~~~~i~Yt2cBd) -Each Installn tion
CfJMM'ti\tvt\J \J - -' "-
m~ ~~M~~o~ER\OD. $ 5000
SIgn/OutlIne LIghtIng $ 50 00
LJnllted EnergylResIdentml $ 25 00
Lumted Energy/Commercial $ 45 00
Minimum Electric Permit InspectIOn Fee is $45.00 + Surcharges
4. SUBTOTAL OF ABOVE
50
b
s
zrD
b 3!!!--
.... ~ ~ n
\ 1% State Surcharge
10% AdmInIstratIve Fee
5% Technology Fee
TOTAL
Shared Dnvt:(T )/Bul!dmg FonTIs/Electncal Penrut ApplIcatIOn 8-00 dOL