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Permit Electrical 2005-12-12
~~ . ~\o\\O",inll '. .' e. · ~ "~,,.J r~" ~"~~~i i ~' . '\a.,~~l \ rlr~ang~J 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:.(541jr2{;::36g9 not ~!~O~C ,\\\9..... ....., , . . ELECTRICAL PERMIT APPUCATION ':~~\O"a\ ninll .~ City Job Number ...ten. \4€>'1 Date n: - , . ---- ---- I. -1:ioCKII0NOf INSTALLA.TJON .'; .~', ~:l 3. fCQM:i>j:.E'ir,;':f"EE sCfjJiQ[Jr;E,jj'ELOW ;':. " re....'. ..- \\P\~ 'ia~ LEGAL DESCRIPTION \ll~~?-A"2.<- ~~\\." JOB DESCRJPTION -\:--e_t'('.~("(\ I"\.A Vnu:er f'cl.'l Permits are non-transferab1~nd expire jfwork is Each Manufact'd Home or nol started within 180 days of Issuance or if work is / Modular Dwelling Service or Suspeuded for 180 days. Feeder 2. I :CONtRACTORiNSTALiATJ01YO~\i ,\\t. ~~r~f~e, o~ !:ee<!ers.':)n~tallatjon, ~1teratioris'o;:,Reloca,l;"on':" j Elec 'cal Contracler !A-.'?-.'i:'</?\~\, r,,1!fJ.0 Amps or less $ 63,00 <1,~ft;. ~ c;,\\t>.'i"";,\\\'6 ~~~t.\) 201 Amps to 400 Amps $75,00 "\l";,,,,"~~'ii)\\~t.' ,9.t>.~ 401 Amps to 600 Amps $125.00 \,,\~~~\\\~~~ 'Vi \~~~. 601 Ampsto 1000 Amps $163.00 \I.~\ :.\P,)iJll€"'2 Qt.\lI Over 1000 AmpsIVolts $375,00 ~~~'-' \).' Reconnect Only $ 50,00 "", ,\0 be C. F;re_mp';faryS~rvice.'1';'rJ;'~l:'d~i~1''l'~~'':.': \eo'v ,p". \\0\" I t II t. AI ",'0/1. Q\0R 1- C,e, "r:::,\" ns a a Ion, teratlOD or e ocallonJ ,\ Uv \\. ~e"" '?J'JV '0, 200 Amps\%r~es~\e \~ O~'?- ,,~e\\ $ 50.00 5 DpD .,r"\'~"r:O ~ .,,0 t;I'<:I ~'" \\V ~\20IvA.!"ps to ~OO Al1)p~0 0\ ,,,,<:-0. _,,$ 69,00 ,,~~ ~O I~Al1)pS1~e~~01A~~S)~\e\"\e \e'v.:."r:.'C-\'~ $100,00 \(,\\0 ,\,00 "r:,\" ,\,,>\0 -\e, ,..,,",v' ~\;.over ,60Q.Ampsior 1 OOO\Volts'see ;'BJ;'above, \'\\'D,)ltB{ai!.ch:Cir,,-iii~~,,~; ;"ii!~ '." \\\ ....~.. . \'(\"'. .\"\e .. 9-J\)~ r:::,CNew,AlteratlOn or,ExtenslOn Per Paucl O~'g'Cif8iit~e(\\e'\ ... Ea~Il'Additi'<!nal Circuit or with Service or Feeder Permit City Expiration Date \ ~ Owne~Name ~Pt\f'€:\- f4:\~A.~ Address \ \ ?- ~ ""\?-.. \ rt' n ' City ~ ~,(b'\t~ Phone ~'\o\\ 01 OWNER INSTALLATION Owners Signature: L.--' Inspection Request: 726-3769 A. [: N~){!ie~id~iitial:Sj:J~ieoi "'tultl.Fanifll'.pei,dwclllngun[ Service Included 1000 sq, It or less Each additional 500 sq. ft. or portion thereof $106,00 $ 19,00 $50.00 "l oj: " ;:".,\ $ 43,00 $ 3.00 E. r'l\-ij;~ellaneri~s(Se;'~ihif~~d'';r:not jhclu ded) ;iEachllislallailon 'l Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited EnergylResidential $ 25,00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges 4.1 SHiJTOTALOFABO~'. ,- 'j '5D pO ~~ ~.DO 'Qc;l..,.W 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnsIElectricnl Permit Appliciltion ~-03.doc