HomeMy WebLinkAboutPermit Electrical 2004-5-18
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SPRINGFIELD
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zbnlOg. and does not r.qUi~pe'6ij;c lana use g
approval.
Zoning mR.
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. Authorized Signature .
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Service Included
. 1000 sq. ft. or less . $106.00
. Each additional 500 sq. ft. or. r ......
portion thereof . $ 19.00 '.
225 FIFTH STREET . SPRINGFIELD,OR97477 . PH:(541)726-3753
ELECTRICAL PERMIT APPLICATION
City Job Number Co.1.1ZC04 - cOS7:;-Date
200 Amps or less $ 63.00
201 Amps to 400 Amps $75.00
401 Amps to 600 Amps $125.00
~ 601 Amps to 1000 Amps $163.00
Pho . ........~~\\'f Over 1000 AmpsIVolts $375.00
!\\&'I"~~~ Reconnect Only $ 50.00
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Supervisor Lic~\llIilrt1 e.oo~ "{hQ$8 'v r n~ ";\as t11 n,:r!;!!/\,oran:.S~~.e~,'!F,Feeoe~,.,.i~~'Jf~~
\o\\o~ I. (\ ce(\\e', "'O~.[r. tJ.~ :,-'\A
Expiration Dat~.~..\~ ~\o_..._(\O"'.()O \n e09\-......~9~~nslaIIalion, Alteration or Relocation
1",' ~ '<JJ- OJJ.'..\ i\>l~~~-^
i 1" o\lll\e.'l ~el. ~,O ..)\\\\\'1" 200 Amps or less
Constr. Contr. ~. ~ _ .he Ce(\ ~...oo~.~). 20 I Amps to 400 Amps
ce.\\\\'~\ \ot \r-" \S ,.&0 401 Amps to 600 Amps
Expiration ate (\\)~\) r.e(\\01 .
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LEGAL DESCRIPTION
(7032SI~
02'-(00
JOB DESCRIPTION
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Permils are non-lransferabIe and expire if work is
nol slarled wilhin 180 days of issuance or if work is
Suspended for 180 days.
rfC5NfitA&OR'iNSTA:rr.'A:tION70N:~iY
2. K'x.- ,", Ln., J'...c:':!f~"~,'~JlWl'..~tt~nil.~:;.:.ti'-~~ >i<'" ,
,
Electrical Contractor .
./
Address
City
Owners Name~~ ~ .J:'.rA
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
. J'~"';j<l'f:"'@!a1k"}P-~.f::~~:i-'~'~~~'i~''t::t:'"'t4Y?ci'"lf''~~~~
B. ,!~er,v.ices'or:Feeoe.rs'~'Iilsfallali!>~l$;,~!J&,~s~~,,~.g.~J!.(IB..~j
$ 50.00
$ 69.00
$100.00
Over 600 Amps or1000 Volts see ':B".~bove.
~':::~":-A"C!'?'~',,"'" Ii~'~'~" . . n "
D. "Branch~GlrcUltS-~ttf~_~"i:':~"'" cc;, ,,'I ,"'~\ ':~.i..'i\h1ili' _' ,J' _':w.' >:',,;
. ._~,__.~_,....~'l. "'_ "'" -', ..' ,,""~'i~,,,,,,,,". " .~ .
New Alteration or Extension Per Panel
One Circuit .
Each Additional Circuit or with
Service or Feeder Permit
( $ 43.00
l{?
$ 3.00
E. iMi,.~~:cit~~~~Jf~d~r~f~)' ~1~h~it~lfllfti1it..
Addresscf,g,p6 ,4~-D .L#-!A:J ll'-~'''''''~"''r'''''''-<;',~_'''"~~''''''_"'-'''''''' ".
City J~.....,,~d" PhoneJd~~ 7tf!./Y Pump or irrigation \\t. \NO?''/- $ 50.00
/' . SignlOutlit9..~\~~ "I ,'21 \,\0"1 $ 50.00
OWNER INSTALLATION \\01\C~~~'i-~~En~~'il~~0? $ 25.00
The installation is being made on property I own wffi~'S? ?'lcBiidJ:t~~'i{~~~clal $ 45.00
is not intended for sale, lease or rent. ~\}\\\~\:.~IyUDn~~'&8rermit Inspection Fee is~ Surcharges
CG~ ~'if~'W~L '~"'''~'"'''''''''"''''.~~f-;l~~''~
0.4 Signature: /' . ~\,\'l i . ~pgkq"r~~~~~~~~~lf L{;-
~ ~/hv7'" 6?. ~~' ' 7% State Surc.harge ~. 'Jlr
;:.;:::.>" 10% Administrative Fee Lf ,>0
TOTAL 52!::S-
Inspeclion Request: 726-3769
Shared Drive(T:)IBuilding FonnslElectrical Pennit Application l-03.doc