HomeMy WebLinkAboutPermit Electrical 2018-12-27CTTY OF SPR]NGT'IELD, OREGON
Electrical Permit APPlication
225 Fifth strftt. Spriltficld, oR ,7.fl. PE(slrf2G'3?s3. fAX(541)726-36E9
This peflnit ls lssued under OAR 9lE-309{000, Permits ar€ nortranlfersble PermiG exPire if tfork is not started within 180
deys of issuance or ifvork is suspended for lt0 drys.
Zoning approval verifi ed?Ey.. ENo
! Rcsidontial E Govemment (Commetcial
Job site address:I {
Ciry: f ,6a a2 Statc:d-ZIP:
RcftrcncC;Taxlot.:
rl
Name:f1 Si.Lnui56r $lf /ttS
Address:
City State:ztP'.
Phonc;Fax:
This insasllation is being made on residential or farm propcrty
owned by me or a mem6er of my immcdiatc family. This
property is not intended for sale, crchaage, leasg or rent. OAR
479.540(l) and 479.560(l).
Signaturc;
Business lame; (g.- T s trra,,s C
Address v
City:'^^L+lr/t\ (Ll./Stzte: CA zry"l'/,llb
Phone.$l | -J21- t1 63 1 Fllr:
E-mail: Jr.rg4\ @ (SIoR, c a*,.
CCB license no.: ltn Jfr1 BCD ticcnse no.: CLEIS 13
Signing supervisor's license no.: l28O LeA
Prirr name of si ln s ervlsor:L V...Ot kl
Signatrrre of signing supervisor: PrnZ OaA*
Pcrmit no,:a 16-
DoDat€ta 23
ResidentirL p.r unit, lcdlce lncluded
S$1Al.0o1,000 sq. ft or ]ess (4)
s 35.00 $E&ch rdditioaal ,00 5q. t, or portian
rhereof
s5 /13,00LimitEd erdrgy (2)
s$ 86.00EEch n sruftcturcd home or modular
drelling rcwice or feeder (2)
Srrvicrs or frcdtt: installalion, dlterction, relocation
$$ 109.00200 Brnps or less (?)
s$127.00201 io 400 qsp6 (2)
S$215.00401 to 500 6mps (2)
s277,00 s501 to 1,000 sllpi (2)
S633.oo $Ove, l,(}(x) ernps or Yolts (2)
$$ 8e.ooRecoorcct only (2)
Tcmporrry lerriccs or fuadrrti lnstdll.rtior\ oherutioh, rclocotion
$ 86.00 s200 slnps or less (2)
s '118.00 $201 tD 400 qnps (2)
st7200 s40I to 600 amps (7)
Over 500 amps or 1,000 volts, see scrvicca or fEcdcrs s.ction above
Brr.nch cir(uitrl dcr, alterution, extension per pakel
a, Fee for branch circuits witb purchssc ofE sErvicc or ftEdcr fte
s 7.42Each branch circuit
First brancl circuir (2)5 86.00 s
$Ee.h additiondl branch circuit $ 7.42
Miscellancouc fecs: seaice otfeeder iot included
$ 85.00 sEnch pump or irrigerion circlc (2)
Erch sign or outlinc lightirg (2)$ s0.00 5
Sigod circuit or a limitcd-cncrgy puel.
alleretiofl, or enension (2)I $ 39.00 S
(A) Enter subtotel of above fccs
(Minimum Pcrmit Fc. $99.00)
Eech additionrl inlpcclion: (1)
$qq
@) Entcr l2o4 ourchargc (.12 x [A)$
(C) Tcshnolosr Fcc (s% of[A])$
TOTAL feos and surchargca (A throuSh D):$ lti,s.
Lrst editcd 7/l/1018 BJotres
E-m8i1:
$
b. Fee for t rauoh oircuit! withgut purchElt ofa scryice or fecdet fee:
Tl $silf$