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HomeMy WebLinkAboutPermit Electrical 2003-8-18 . , '.. 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(~ IfIJ7' Authorized Signature LEGAL DESCRIPTION I 70 Z. '3 )'t( JOa DESCRIPTION :z 5-l2.v<":> ;/ b C.I~' I s 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 /I.ft.! '{ 0'6 o ' II.( 40 /hi)'If{ rr~;;;~:fLt~ '-- ",... 4. SUBTOTAL OF ABOVE Inspection Requcst: 726-3769 TOTAL Shared Drivc.."(T:)/Building Fonus/Electrical Pcnnit Application I-03.doc