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HomeMy WebLinkAboutPermit Electrical 2006-2-15 :'.~.'. .' CITY OF ~d{INGFIELD. .oRE'doN . '>', .'. . .! j'... . { , . .' " " , ., _ ' . - ~. .." 1'1" '0" . I <to -," ,~. , 225 ~U' In STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COM.. 1.COd,.-OOSbS Date ~ ';':. ~~\o:>~ 1;',. ...,' "!:;....~.-,,.,'I\.; .",~>.,~.~ ..'.....:'~rr':.,r,'-'..._'~~"".~..:., :'.' ....~.:t~~t',-'i">;., 1. .t'IhCATlON'OF,'1NSTALl1ATION1~{'\\'f:!:l';~i \'! '.;.,'>.' ',; . .. '-...., :-.,_'",,; ., ,.'. '.<:'~:: "..".,.,.:.~,.:-.:.. "j ,~..,:' <_.J:,>!. .'.c' ':1','" 6rt\S 1-\ ~ <L c...o w t'o I-. i;) LEGAL DESCRIPTION ne~ 2. z..4~C>Tz..o c JOB DESCRIPTION l"lew Co~t'4te.~L 3 L:bG. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. , ' bmittad ha~ the following' O~1.~'~::>:~' .",;~~~~~:{i;:~,~!:~::~:~::i~I~~~ :::'Ml' " 3.'(XJMJ>LETE)FBB' , 'EDULE'BELOW,!;;;,~~,':')'F')';\ ~, .' '~.':'... '/'>."' - '-t''- ""~"'dl'z6'iiing\' :~'''' -.- . .,' _. .\,..;.....\- - ~'....\,., ,,~l.:...~\~.'>J .?_\~-Oll - 'Si\.l\V~:~ "-:2?"1~';;'~.~'~.Q?!-~~; ~. "".:I""''':i'.~r,~\.,;:~,'.:j:::'l''' ,?,~.t.>.e',!~~\~j..~i~t;~l'~~~""''!;)'-1~'*--\'~~1ti-:~~ A. ,:N<,!, ~~',~~~It~;rtI~\~Jt'5~rg\\f.iilU::~.., {~;:,,!~ug'II01.L,;,,; 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 $106.00 $ 19,00 $50.00 '~'ro~:~~l~~~mst;'~~'~TIONt(JNLYt: B. .;~Sl~1~'~i:~~'~'~ 1~'~' ~;~'~t1iU;i~~~~lt~jfii~~~~W/i~i1~k~iiJi~:'~ 2. ^""~"":'_'_' ;,.._.,'~t.;.! '."":",~""<""~''':;'' ..~',...."'""V:....l,:."',,".,,.- ,,:.\, ).~A>"~'-J'~~~'. _30 j~" ,.",'.' "," "'I""!"""'~'~' "~II.' .""'.,.~-."\ . ..,.. ....,,-~- ..' .,....., ,. ~\'1...~'t\i\\\~".... ..,...... ...".............,.'. ElectricalContractor ::)''?, f:\f>('.k'" C ~~~\91Ilt&9\o\'fl\\\'\ 2. $63,00 \"-10....0 Address 4(0<;<5 IsQ~i\t<> ~~~o~~~~~~~~~ \ ~17;~~~ \"LS.c>o . 0'1' ,..,.... ~I:l.. \"2.,;,.~T'! \!II) . (\'< ~~' lrR.ce :\.Q9fl\[)::",:.~\ns;I~O~~"'P \011 $163,00 Phone . ,h!07-.Q'iJ o~I16RR~~\!Ii~\~\" $375.00 \(\ U '(aU ~ ~~n~C'i\Qlil~ ~AA), $ 50.00 3"3' '7 J.. <sO~\\l'IQ ~eO~~Il':\iI!Q1Z~~~.1~~;S;Z~"';:'-">~':::'F"11-~"'fi;Si'~-!i'i':i'~"~~,;":'~t\")"\1'i\'1,t'<V>'::7,g~(, Supervisor LIcense Number . - ...... .......t' 'Af ,m orarv. erv.ces'or, """ers~'~',' ">""~:O; ",.~~. _".t...~. .,.~"......' " . . ~\#~ ce: ~I' , ~.,.:_.l'j .~,.;1'"".,......-.,-..~........t>"."~""'f!,""'.~}'~~\~t:$,(I;, ~:!;~"0~''',,:.:,,'1 Ciiy EV\ 3 '2.......<" Expiration Date I () - i ..0<-+ Constr. Contr, Number i G'i q J q Expiration Date 3- I '-j - oR M SignatureofSV~ f Owners Name I.' L S 'Z..s t.S Address ~Ol.. 'tl l N.G. S c.. ^L '{ 0 "~cq lk> t'\t> City Eo o..e.~E- Phone gal USTE..\> OWNER INST ALLA nON The installation is being made on property 1 own which is not intended 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 $ 50.00 $ 69.00 $100,00 Over 600 Amps or 1000 Volts see "B" above, '.'~ti'':;!i.'\ ':":"("'-,',_::~-"-:"l'b..c"~r<.!t';:,"'i~',21.'~~W,'''-'''~I~''''h~\",~'r-\~~';J\",'.~:-r,f.',~';:.q)\~\,.. D. ;~ BralidI'.CircuitS~~\:1tv,r.';; "~il~i~h'fl..l.';:.t{;,. ~f..\'.!{~ "~_':iRil~\'15~~~~~.~\~~~;tt.~< '~"~''''''''' ".~"U';'~" ~'''. ,/:lJ,:."~,~~,,, {;iil\:!>j'f.i>'~v~\;~,:;;.,:~*,~r- ,:.,.i.,-:\...-=~....:;1~';f,;...i-'}' '....If''f..~\ft~..' ,t~ New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Permit S 5 $ 3~~ lloS. 00 ~,'::;t:lWv':: ':'~'+',,:' ~~-"~,' :"".;..::::t,:hj"~l'd;""""""""'\i'~~~~~~(\\ '<" '-~'1..,~;>.\:;:", E. ",1\J!~~e!~n:~.uS~(~1Y..!~o/.~~~\\\~i[~t~~C~~Jn.~~I1~~i.~~)' pum~~b\~~~~\\ ~\\:~~?- \\\~\(\Cl~~\)~ 50.00 Sign!~~\lfn~ 5~~ \} Cl?- \~ \>-.'0 . $ 50,00 . Limite~.;' ;~Q.\~~t~?-\Cl\)' $ 25,00 , Limited '6~Y(~~rcial $ 45.00 Minimum Elec~~c Permit Inspection Fee is $45.00 + Surcharges .~:,::' .~ -,,- d}. .''';''~ .:-:j::.ti.-':' :~,n?) ~r?i :,:'t:r.::;~':;;~Fl.i;,~~~\ '\iJ~:{i{; V.t:~~i1 4. ~'SUB7l)TAL',OF)tB01lE';g'!ic~)'~'I.:':~A~'~~;,~'1'\":1~\'-'l~:)~~;.'~ .>:: .~ ;~.'..r..~.~.,;..:.'\il.'.' I,..; ,:: ;;':;:tt..~;,"';'.:.: :'jy.',.\':.W'::'.(~t"l :~~:.[;~~~':r':' ~ 4lb.oe '2. ~, t'Z.. a,. \ . be ~"'. -t"L 7% State Surcharge 10% Administrative Fee TOTAL