HomeMy WebLinkAboutPermit Electrical 2004-5-25
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ...,f,/ilf'QA~c1J~;'r;'~'''.Jbmi"edhaslhe'o''owln
ELECTRICAL PERMIT APPLICATION a"proval. 01 req~~peclfic land use 9
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LEGAL DESCRIPTION
17.03 . 1.2. 00. 0 A.30 h
JOB DESCRlPTION'
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, CONTRACTOR INSTALEATlON ONLY' B. ".(,.-.:~._S.'.'..~rCrv..~~_'~.::_.c..'.-es..:.').~.'~.:!.:..,F......:e....;..d.~..r....~..~...:.~,..:~,:...:.,';!}.p.'..:.J...t....i~~~.~!..,.I~A1..~.,;J_.'~~....~
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Address PO&'X Qn
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Permits are non-transferable and expire if work Is
not starled within 180 days of issuance or if work Is
Suspended for 180 days.
Supervisor License Number ~'" ~
Expiration Date ./.' /0- /-()t/
Constr. Contr. Number L7 t 'Z. tjfI
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Expiration Date
Owners Name ~ ~'/.L l.A.-.l- Cc.
Address '"'"P.o ~~ Ib4!O .
City ~r JiP
Phone
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OWNER INSTALLATION
The installation is being made on .,v._'" I own which
is not intended for sale, lease or rent.
Owners Signature:
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106.00
S 19,00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIV OIlS
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
S 50.00
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Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 VollS see "B" above,
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S 50.00
S 69,00
SlOO.OO
New Alteration or Extension Per Panel
One Circuit I
Each Additional Circuit or with ~
Service or Feeder Permit
$ 43.00
$ 3.00
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E. ;:Mis~.jian~oiiS"(S"n1""'feeder not b1C1iided)::'E.ch'InslaiIallo~',
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Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial S 45,00
MInimum EI~tric Permit Inspection Fee Is $45.00 + Surdiarges
4. !~~~t?115g{~?,~;i~2~~';:~~~:i'~:~~:~,
52.,
3 . ~y.
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ft[J'. 01{
7% State Surcharge
10% Administrative Fee
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