HomeMy WebLinkAboutPermit Electrical 2003-8-18
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, '.. CITY OF (..-/ITNGFIELD, OREGON 0
225 FIFTH STREET. SPRINGFIELD,OR97477 . PH:(541)726-3753 . FAX: (541)726-3689 . h f \I wing
The following project as submitted h~.S t e 0 0
ELECTRICAL PERMIT APPLICATION _. / zoning, and does not require speCific land use
City Job Number COwtZoO:> ..c C 0'1 b Date ?5/ / .y0 :3 approval. A."DR-
I Zoning ,
3. COMPLE1"E FEE SGlifI'DULE BF1()W l1. ~ l( ;.() ~
~IA )
I.
LOCA110N OF INSTALLA110N
76/0
J;1It C{C&ve(~
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Authorized Signature
LEGAL DESCRIPTION
I 70 Z. '3 )'t(
JOa DESCRIPTION
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Permits are non-trln':ferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
O/Lf.O(
A. New Residential - Single or Multi-Family per dwclling 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
$106,00
$ 19.00 ~
$50.00 "T
,2.
CONTRACTOR INSTALLATION OND'
B. Services or Feeders -Installation, Alterations or Relocation:
Electrical Contractor
L
$ 63.00
$ 75.00
$125.00
$163,00
$375,00
$ 50,00
Izb
200 Amps or less
201 Amps to 400 Amps
401 Amps~Amps
601 ~~t(S~ Amps
Phone ~~~,~~Q6.A~IVOItS
~~ ~'rt' tJ5n't'y
j\ ~'r\..\.. \~ ~~~
Supervisor License Number 1\( & ~~:.-..\\~ S~~'V~~ ~'O~emporary Services or Feeders
~' ~. ~'<-\' ~\l R-{:>~.
Expiration Date 0 ./ . \y-\~,^~,?,-\~("~'V ~~~~()Installation, Alteration or Relocation
or\) ~~~'C. ~ 'V"<' 200 Amps or less
" ,'" \ 'Q 201 Amps to 400 Amps
y.,\ 401 Amps to 600 Amps
Address
City
Constr. Contr. Number
$ 50.00
$ 69.00
$100,00
Expiration Date .
Over 600 Amps or 1000 Volts see "a" above.
.. \0. .
D. Branch Circuits S ':101) '\'~':1
u\~e 1,)\1'\
New Alteration,or;l;;'tfell~6~pe"\Rii!:'el
\,clo" 0""" S'" 0
One Cir~jp(\ :-J \'(\0 S ~\0 9f;,?J:) \ $ 43.00
Eacli.~dditio1thl Circiii}%r-W1'ii1 \1)\0'" / (7
....-(~~~S'e';...'i~q)'tFeeli.gl>~l'i'V~\"0 "db $ 3,00 Ii>
Owners Name Ct+AU<:~ "K.IlI er s L ~ ' >tl \1)\0-:> C.0~\0\~\ \) ~\V ~~0S 0 \0\0~\ '-~'i.\0~ .
Address 7b, 0 W C{Ct::7f('c r<:: tf KI-./ \O\~~ c~:\O('Mj~,c_eJl~n~,!is'(s~~~lc~ltr~d,ejJ'I\~?inclUded) -Each Installation
~ ' ~O\'\~ c;.. 9~7; ~':1 a\) 0\' \.~u I,)\\\\~ ?,6,A'\.
50 P r D Phone \(\ O~ .l\uml:>~3iriig'it5'.n~~o~.?,?,'2.''2: $ 50.00
o',I?; ~sigflt8.utlirutLighti8'-("j $ 50.00
Q" ,v' \;;J . It!;
c.,I,'imftkd.En~f~y/Residential $ 25.00 .
'(\v' v"'" .
Limited Energy/Commercial $ 45,00
Signature of Supervising Electrician
City
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
7% State Surcharge
10% Administrative Fee
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4. SUBTOTAL OF ABOVE
Inspection Requcst: 726-3769
TOTAL
Shared Drivc.."(T:)/Building Fonus/Electrical Pcnnit Application I-03.doc