HomeMy WebLinkAboutPermit Electrical 2004-5-11
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225 HrlnSTREET . SPRINGFIELD,OR97477. PH:(541)726-3753 .FAX:(006~1l71U1d63DSe~~t ~Ing
ELECTRICAL PERMIT APPUCATJ9N ..approval !~Clf.~.
CiiYJObNumbe&[Y)d~ -tJO/7fDates..b.; ;ld12..foate zoning!s-'/I_0c? '. .
1. jff0CA..ifioNf6F,iNii;r;;1';,fiio~~ 3. tirc()MPiiliwPE....ttW~Ioit',oil!~_~
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LEGAL DESCRIPTION A. D:lf~~~~~~1..ffilii.s~~tti1k
/103 3-5 4/ 07;). cru Service Included
JOB DESCRIPTION . 1000 sq. ft. or less
"A . J //1 . J. . Each additional 500 sq. ft. or
~ Ul'rP / rt .A f~ I~~ portion thereof
New Alteration or Extension Per Panel
One Circuit $ 43.00
Each Additional Circuit or with /0 _ <30 . Oi)
<.:..-.-.' Service or Feeder Permit $ J.OO .
Owners Name I... y n PrJ;c;-J. 1 J/ P.A.IYl G2- . . .
Address $// ~ .:/2(1"/)_ yh~E. ~m~~~tr~t'(rrfJli'\~if;jTh1~t\illftiiffi
Ciry>;-Od Phone Pump or irrigation . $ 50.00
.. q 7'-i 7)( Sign/Outline Lighting $ 50.00
OWNER INSTALLATION . Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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Permits are non-transferable and expire ifwork is
not started within 180 days of issuance or if work is
Suspended for 180 days. .
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2. l!>~~g9 .ms:r::'" TION.;ONI:;Yi
Electrical Contractor n,.... ~ E I~c..r-r..c..
Address
tf?o. glJ>< N'f .
City /!!:.../e. /~ ~
/'
Phone ;;'):2 ~ J::LJ L
SupeiVifdrJl!:l~~oo law1~,~yS. <.0--'
.1~;'().w rules ador:Jted by t~e Orl;lgon Utility
EXpU'8norlIDat~eni?r0rr~~.. 6... ....t f,,'It'
in OAR 952.001-001 0 thr,9U2i1..o~2-OO1.
d:lastr!.6'611tr~ai.n.69Pfi?'s g, 11A!l "v
calling the center. (Npte: the.telephone
ExptitltiOleOOe thei?reg0'A' lnifiRI ~otiflr.Atlnn .
Center is 1-800-332-2344).
Signature of Supervising Electrician
y~~
The installation is being made on property i own which
is not intended for sale, lease or rent. "
o~ature:
Inspection Request: 726-3769
$106.00
$19.00
Each Manufaci'd Home or
Modular Dwelling Service or
Feeder
$50.00
. m'l1!:<'Jf--""-~;:~~-~~'~"'~"; ."-,,
B. Se<:V1ces,or.FeetlersS!!ristall.affiiJiJt~lt~ralion~,oc; RerQ~ation:
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200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVollS
Reconnect Only
.. / $ 63.00 ~ 3
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
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Installation, Alteration or Reloc.ation
. - -...., , _. .
200:Amps or less' _ $~OO
201AInpsJ'i il'do Alh'PsLL EXPIRe I~ I nCV'$~ .
4QILAJiJ,p"SIfO:liOOAlhI\SER 1H1S I-'tKIVl1I I~ ~O
'D.~
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:;vBuilding FonnslElectriClll Permit Application 1-Q3.doc