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HomeMy WebLinkAboutPermit Electrical 2008-4-30 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number CO""", ZooB - 00 Z 7 3 1. LOCATION OF INSTALLATION: Zl/-SJ- / /,.{.f... ~t LEGAL DESCRIPTION: 17D'3 Z<'("3 l( JOB DESCRIPTION o Z- ( 0 c:::J 2 c, V-c.-.;- ~ ... Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ZON INITIALS DATE SOURCE Date if... 36- olf 3. COMPLETE FEE SCHEDULE BEWW A. New Residential - Single or Multi-Family per dwelling unit. Service Included 1000 sq ft or less Each addItIonal 500 sq ft. or portion thereof Each Manufact'd Home or Modular Dwelling ServIce or Feeder $117.00 $ 21 00 $55 00 ~ ' " , 2. CONTRACTOR INSTALLATION ONLY B. Services"or Feeders - Installation, Alterations or Relocation: J ' r- I rrrNTION 0, P."'nn i;:u...._raq" , Aa" Electncal Contractor .........t'"V, GCi fA l-.4-f' ~.R~ 200 ~s (5rll;;::;~ lIJres YOU... - , :;0:_ ':,rv rt1f~;-,32tnri<ir)p~t'otij6b~9n~ Address .38qq- ''i<CbQ:;ueL-I- I.~i U~~-\:j~1~~f.tg~1~~9~~_~~ u090. You may6Rh~WPM'P~sog?t~srules by City C:;(D.?'/d. Phone 9v'-/~g the c~r.1~~hte?liNJr~~prwn. IIImber for t~~h <mlnty NotlticatQa ~.J Cente. IS l-aoO-3322344'_',t L 7 g ~ S c. , Temporary se~ic& or Feeders SupervIsor License Number EXpIratIOn Date /0/61/ :'+0/0 /7 ''583) / ~ ./3r-~ ,/rl-cYJt. Constr. Contr Number ExpIration Date Signature of SupervIsmg Elec~~ ~~. /-~ ~~ ".-- -~~ .... Owners Name J "'" J~v 'Zl(5) ST>r~ Address ~(l,~v J ~. +-"'- S r- ZZ f .. c..( , J ( City Phone OWNER INST ALLA TION The installation IS being made on property r own which is not mtended for sale, lease or rent. Owners SIgnature Inspection Request: 726-3769 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 V olts ~ee "B" above D. Branch Circuits $ 70.00 $ 83.00 $138.00 $180 00 $413 00 $ 55.00 $ 55.00 $ 76 00 $110.00 New Alteration or Extension Per Panel ( One CIrcuit $ 48.00 Each AddItIonal CirCUIt or with ~ ServIce or Feeder PermIt .V..L.r..$ ~.~ /" 'omB-\M t"" \J\I\-~\. . " '" - n n~:lN3IAl\f'm~1 E. MisceVM~~~nf!~~&\-\1bt i~'-~tM-1!fl~ Installation t.l C.'~'\'~ltE1r1 S\~l B3QT\ffi (1 - ~\\-\ t pum~Qt'llii :itJ~h ~13~-11r1'X3 ll\-lU~ J n'~~1~5.(),ON SI~lli\ ~tmg . ::r$"'~5;.l)6 LlIDited Energy/Residenhal $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges , <2 4. SlJ.lH vTAL OF ABOVE .../ bz'r 12% State Surcharge 10% AdminIstratIve Fee S"Z. ~ 5% Technology Fee Z bO bbOJ- s~ TOTAL Shared Dnve(T )/BuIldmg Fonns/Electncal Pennlt Apphcatlon 1-08 doc