HomeMy WebLinkAboutPermit Electrical 2005-9-13
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225 FIFTH STREET . SPRlNGFIELD,OR97477. PH:(S41)726-3753 .FAX:(S41~~ "!\~'".' 0 'c,
ELECTRICAL P~RMIT APPfCA170N. ~",0' II>' '
City~O::be~ _', .:;;;l:~ .~,".~,~te ~r;, _ ... ,,..,._.., . ~:~~~~~9:"j'~~""";1
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LEGAL DESCRIPTION A. :-Ne~'~~4iittii~~~~ij~iti~E'-aiPiiY.)",~~~~~,~m~~'~iht;::t,
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JOB DESCRIPTIO - -r~
~-~ansfe:able expire Ir~o~~
not started within 180 days of Issuance or If work Is
Suspended for 180 days. '
2 flreci~~!:r!iJ'A1iI6N!ONK;i
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Electrical Contractor . . W <: 1- I'~' 1<',\ c.. 200 Amps or less qU\leS 'IOU \0 $ 63.00
n 2Al~fJtcOIll~~SO egon UI\\\\~ $ 75.00
Address r, 0, Rfl7 1 C; t{..e:- f>.ii~Ni4'o'i~fJlo<660'Iknffl\e~ aJe set \U~~:'. $125.00
," " .., 10\IO'lnUtR~'to 1ooo<;~ Of>,f\95"'vv'. $163.00
City z: /:, I't p,j,J e/ Phone ~ 3 S . 530 ~otllICa~~w.ooiAil?P\\%%~ oltne t\,.v::'1 $375.00
J In Qf>,f', "Rri?lli'e<lt'!ilfiIY' C , tne tele\-,' 'V', : _ S 50.00
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Supervisor License Number '"6' \ ca \:.\~~~,,~~e~r~~a,rsj:...ftij~~';"tr~':l.,_..nt~~;~~~~~~~i
;' ( numb . nlel is 1-oUv .
Expil1ltion Date 1" 0 \ ')..00'7 In;(,SJatlon, Alteration or Relocation
, 200 Amps or less \
Constr. Contr. Number q 1 C l t1 201 Amps to 400 Amps
401 Amps to 600 Amps
r: - 20 ~ ')..,OOS{ Over 600 Amps or 1000 Volts see "Bn above.
D !i1B~''::!.;':':':::~C"::lIiI,,...~',..,.,o:,;,~ts7';'~~~*,,,}\.~_=1:~~Tk:-.\;'4-~- '''r'-:''(.!~ ~,., ~~~'1}'8i::.~.Z"'~-~J
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Expil1ltion Date
Sign~Of~ng~ElecL)
.
Phone
i;
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
$106,00
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IA
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B. ~siiW{~S16~lf~efi~1s~itlilifiti6m.~~rtk~1i6~i1{~tifut~~
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,$ 50,00
$ 69.00
$100.00
~!J'
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E. ~,~ira~~~il~~~~'i~~tAd~):~~~i~~~
.Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00 ,
k~ted EnergylResidential . ~ ~ $ 25.00
~Olh~EROOf~~! ~ . - r 9-1$ 45.00 .'
~ F~~N~~~.i~~;;.surCharges cJ)
~~",~,,,J\~~!i1i~',';~~'~ ~
10% Administrative Fee ~4 .!.aO
TOTAL 4lJ~.~
Shared Drive(T:)IBuilding FormsIElcctrical Permit Applic:ltion 1-03.doc