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HomeMy WebLinkAboutPermit Electrical 2003-5-13 CITY OF S()NGFIELD, OREGON ",,,0.,,.. " bmitted has the tollowin9 uire specific land use 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 .<F'~:~~'lf:f6~~689 I".A approva~~"t' V'\l r- ELECTRICAL PERMIT APPLICATION -I, J. Zoning ;"'l~- 0 ~ City Job Number (OM 7.nc."\ _ <::>0 Y-f, Date "ji/ Y_d_'5:~"tc . ~ I. LOCATION OF INSTALLATION 3. COMPLETE'FElistif1f5'f/LE BELOW b T>"-( 'JA CO cf Cd LEGAL DESCRIPTION 17023'11/ 07.300 A. New Rcsidential- Single or Multi-Family per dwelling unit. Service Included JOB DESCRIPTION 1000 sq, ft, or less Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or . Modular Dwelling Service or Feeder Tt:WI P i?8ve1L Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 18.0 days. 2. CONTRACTOR INSTALLATION ONLY! B. Services or Feeders - Installation, Alterations or Relocation: Over 600 Amps or 1000 Volts see "B" above. D. ~Bra~-~h-Cjr~'uit;. --- --"- ..- - ---- ... \0' New Alteration or, I?,xt{,;~ion'fer Panel u\\C"- - \)\W~ One Cirq;,i!1 ~eo.: ,eQ,O\\ ~ \o{l.\'I EachfAlliaitinnaR:ircuit<o\,,'a,lth\Q'\ . -"IV'!) ",,,--v' ""V' r;.,.(,.,'J $ ----..... O~'.\:;ervice\or'I'Cedel,rPermit, 9.. S "''' 3.00 Owners Name .J.:)t::7'f(lfr:> .(Hr..v(<A~\~ ~60'9'--<",OS'" ",Ut'" ~\}\e ~~es"",~,'II' 'O\}Q,\' '~\\'Ie -\\0- - --" ..--. ~ Address "'67'1 r T{..-.~--sJv- ;:1. ,.\ ~~ ^t.e\\l\\Us"l'lla'i\~ou~,(S~h;is.o/R~dler~l1ot included) -Each Installation _ - ,0" Q,\.I)'-' "'(\CO'lL \\'Ie'V" '~\ea>' .. - - --- - - -- . C P Cf) . :i.\~\Ce: S'l.'Cl 0'0\'3'\ \,,\e'. ~O\~ :> I Phone ~O ~ f>,~ <:\ ~wj1p ~'i;irrigatio'b\\\\\'l ~c.A")- $ 50,00 \\\ ~~". ,<01) "Sign7&tline-;t9(\ghting/2: $ 50,00 Q'-'''v . '\II' €,V' 0"''''' OWNER INST ALLA nON r'i}\\\\\'tJ, l.:mi;a,o'En'er~lResidential $ 25.00 V :oe,' leI Iv The installation is bei~g made on property [ own which \\I)~ Cinfited Energy/Commercial $ 45,00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surchargcs Electrical Contractor 200 Amps or less 20 I Amps to 400 Amps . 40 I Amps ~o Amps ~OIA ~1.,9'iJOAmps e~' ~ti~&,psNolts \.. ~~~ &.~liUi'JY ~~~ ",'x" ~\(\\)~- - - - . - - --. ,~1\1.."~~' :J~ SJ:\\)~~ ~~\"TemporarY_S~vic_es or ~eeders _. .t\\U,: "<~~ :t~\) \)~ '\ ~. J J r- ....'(.\;\~"'~\ ,,"'5~ '?~~'iS Installation, Alteration or Relocation I o - ~\) ~~'i;..\; \)~ 200 Amps or less (,'is ~\ \~ 201 Amps to 400 Amps ~ ' 40 I Amps to 600 Amps Address City Phone Supervisor License Number Expiration Date Constr. COlltr. Number Expiration 'Date Signature of Supervising Electrician City 4. . SUBTOTAL OF ABOVE o 7% State Surcharge 10% Administrative Fee Inspection Reqnest: 726-3769 TOTAL Shared Drive(T:)/Building Fonns/Elcclrical Permit Application 1-03.doc $106.00 $ 19.00 $50.00 , $ 63.00 $ 75.00 $125.00 $163.00 $375,00 $ 50,00 . $ 50.00 $ 69.00 $100.00 5-0 $ 43.00 50 5~-D SOD -8)'0 ::> .--