HomeMy WebLinkAboutPermit Electrical 2003-10-9
. CITY OF (/UNGFIELD, OREGON 0
225 FIFTH STREET. SPRINGFIELD, OR 97477 _ PH:(541)726-3753 _ FAX: (541)726-3689
The following project as submitted has the tollowlng
ELECTRICAL PERMIT APPLICATION ,onll1g, and does not require specific land use
Cify Job Number <0"", 'Z-Cio3 -0 IoN Date 10. en, o?> approval.. f2--CL-
Zomng
I. LOCA110N OF ~NSTALlATION 3, COMPLE1'Er.~ SCHEl>l iI E REl,(lW /0- q:J
4.;<\,\ -e:, ma,<'l~\, (<SOFn>'t CI:jSlt) "",,,on'60 Signaturo 9}
LEGAL DES~RIP~~~L.3 '2.'3 Z. cn'7 C)C> A. New Residential- Single or Multi-Family per dwelling unit.
01(\::.'01'\7"\ F \ ':)~f':::;\-- <S~~f':r:NE, crv;:, ,Scrvice Included
JOB DESCRIPTION lOLI> \a>O,..... C)IQJ" c=\(,€,5 -1000 sq, ft. or less
\l\\IJM:NA-TE'D ~~l\o.>:> Av::>(\i.l\~ lv>'~ EachadditionaI500sq.ft.or
a.J~ 1'",,' cC-. . portion tllereof
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling SeJ'\'ice or
Suspcnded for 180 days. Feeder
Electrical Contractor m"-\rt>- L.:Je"',\,> <<I 'S,,,(\ ~ Awi1;~b Ft4~ or less $ 63.00
20 I Amps to 400 Amps $ 75,00
40 I Ampsro 600 Amps $125.00
60 I Amps to 1000 Amps $163.00
Over 1000 AmpsNolts ,'O\)':':'~'l- $375.00
Reconnect Only ~,t0'" ~ \,)\\'i,a-<i$ 50,00
\001. f/P.JO 'O0\; 1P
c. . Temporary se'Oi~~~~~~~~:"~c;,'a: ~~ \ .
.Ot0~ ~'O~ 0~ Ol"'~~ o~
Insta~,\~; &~'r'ti.qd'~~b'c'\!l~e\e\)~ ~o(\
~~'\f.3~~ !fiet. ~a~ OO~\~~0\,~\O~ 50,00
Rb,,",~~~'~~~~~ ~o\0~~,~ ;,y.'" $ 69.00
~.t\~\'llIlt~ ~Q.i'~({\'0~'~O~ r:l,:?:t $100,00
i\~~~~~.(jr~~~I~Q~ "B" abov~. ,
D. ~.~~~~\l\ro ~\e~\"',
. ,~'O r.e,
New Att.'Tation br Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with c::i'-~
SeJ'\'ice or Feeder Pennit t,. ~ f::j\00
. ~\l'\ ~\':I~
E. Miscellaneous (Ser\'t~d~'~<;)~'a; -Each Installation
~. ':I\\~\: 0. ,\\\':1 f::j~~~
P~~~~ 'U~~'t." ~'O~~ $ 50.00
Si~~l?I1~~n~", \\~. J $ 50.00
Liml~~~~;~~ $ 25,00
Limit~~~'M~mercial $ 45.00
Minimum EI~~t Permit Inspection Fee is $45.00 + Surcharges
2.
CONTRACTOR INSTALlATION ONLY
. TK:rl:: 05
Address ~3 S. s- S, . I I
City 0fl7i"')'Pi ELbPhone
7l.f &" 33\02
Expiration Date
ESSe 'S\G\
LO! 04
Supervisor License Number
Constl'. Contr, Number
\d~S"f,ln
Expiration Date
Li, \ 6 . olp
,
iSin~
'--"'"
Owners Name ~() T{\~F<;;TW)f'l'll klL~
Address 3d/." n1AiYJ 41~
City ~~"~S\'HIL- Phone (,,~o-qOD\
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
$106,00*
$ 19.00
$50.00
B. Services or Feeders - Installation, Alterations or Relocation:
c:;[), Ct:>
4. SUBTOTAL OF ABOVE
<q).OD
3.50
0.00
~"b . nO
7% State Surcharge
I 0% Administrative Fee
TOTAL
Shared Drive(T:)fBuilding Fonns/Electrical Pcnnil Application 1-03.doc