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Home My WebLink AboutPermit Electrical 2002-8-13 .. 0.... ~:~,;,. :"'f~25 FIFrH STREET.,' .>'i:!,~~'~~~;(.:~~;' .,f,c", ELeuCAL PERL'-'flT APPLICATION.' . :.~ ~"~'I.. ~", ," '.~ -An::~~0l\<"Ci"'...;:+n~ ,: :",~",;-,-" ,';- , '..' (\':r" ..' "...... '." ,.,.~. ,,;""""'" l~SPRlNGFIELD OREGON 97477 if;;"....~" "~~)' rr,' .f' .;,,: .",} :.' ~;;'!~{~~TtQ)"':@('~~~ "\' "" .:~,,~,...;....~. lit:: .', -. "\ I. .. N.. g~-~ t~' r., . ;~.., ~t, "J:-' ,.','. ,':.' );-\' " '.~;'1; t;_, i;-. : '..~; .,:','~.'. -,"t'-I:'" ":~::~['-' 't~':'~<:, !;l()NSPE.c:r,IOl':',REQJ!Ejg;, 729.;J7..r.,g.~~ l 'l"",~;" <J',;Cit)~.Job l1u!"be,>,' '., ':', ",\." ',:'t .;:;'..:)1:; ~.:,~~~, ~:~OFFICE:,':.726':3759~'~~ ~~;;. ~'lt~~ . { _~.~ ~\i ~\ ~~ J?~'~~,,;:~:"'''..;i~~Jcr.~~;~~~~.~;.~t':.~~:{f.~ l~,;'~l'~}\iu,.':?~';~'1 >;;.>,,~ ~,;,t ~ 'i;9..r1;\~ ~\ ':': \~\'fi k Q~""~r '" 'f~' ',,;'" ..,COMPLI~j-E FEE$CHED, '. uL?~EL()\v;b:",~~i.,,~':':!~',; !f~.: ""~~4~' ~.. ',.. $-.. .. ~~...... t' -' . ".~i:V:;........*>::;'...., '~"2."~" );. -. .;r..l,...\....~.~...'....~l..... 'J:'~ ~.'f\'." :.~:.(". . ,'t-'.' 'R,~~.~~i ~f; 1. ~~ ~~N .. r~' .. ~. "?<r-: ~.~Fl.:: !'1'r.~~?~1\r r~~;.1~i.?:;.J~,~.i-..:.~~k.....i:t.,.,:.t~;\.\(::'~.~.':~:.....'M~."-,f3:;:'I~~:, X.',;.:,"' .~.,t. 0" ~. Ii: '. : "".:~' . . .; .i;~, $ i!lA$"'N"" .-~t"R'''r''''''d t' :-1,'S' ~ - , 1-' .PJ)..y,.,~!~; -..~.':'~:\; '.'.';~I\: :.~..'~~~.' ..:...t'i:';..' tf, ;;;J . v n .M.. ew CSI en Ia - mg e or ' ..., ,,'''-.- ....~.i,..,_ '. .. . ....... .. :;~~.!~,:r "-" " ;;?^O ~ .. I . F'\ d II' .,.:M " 0<::' ~o v ,~' m.U tl- ami)' per we 109 umt. .-:'....,.S:~, LEGAk~Nl't~. <",,*'" Scn-ice Included: tf~:;; '-IUl..:>'t\\ IL ,i> Items Cost Suih~; , ^ ,.. I ~" .. .,' v -s:-o .-;.1....., :,~,;,:.;:,:'""":,.:"~:~.:,'.:",:,,,;,.~,,,_,:.,.:"_,',',',~.',.',','~,:;,,.' J~~~T~U R~ (()~ ~;~! ~~,~~~:~s~oo $106,00 "~:~?: ,:':~, ' Permits arc non-transferable and expire 'thereof $19.00 "".\";~ if work is not'started within 180 da}:s Each ManuI'd Home or ::l;;. ';~;,','" i' ", I ~s~uance ,9\ if work is suspended for ~odular D;el1~ng ,J1'W::::, ,,:~ $ 50,00 .''.!!~': 6'? 2. a:~2.rOR ~STALLATION 07\ y B. SCl>'ieeeSr\~:::.:dee:S el l<~~$~~;~J~~i~:', .Jt.~: ''':~.k :;.;' ~;,:-,.-:::.:< .~.:.'<;. Installation, Alterahons or~ '~'f.'."'. :'~\,:- . .;,,' . <(;,.;, . ~i~~ :,< Electrica . C~~t\~lctof~:.~r~ Relocation: ;~lti~~~~~f~;i~ :~~:?;. ~',::~4. >. \'ff,:!): ,'" , '..", " ~ .,%~'I;,.", ,,~, ,,'.,.'.' ,..,"',..' ,.CO'" ~........ . '; ~('~.~ ~.":;'~ AI,. ;:'\~~'!'~'.'--:G::" J.:: ~~r,. 1~':.,1t,\. ,\. "i.""'~ ~l\1;'. '1 1 X ~1-", l.-f.~~ ~. "'~'''''~il.r:''l'.'o{, t- -..r. -... r.,,,- 'L' './"':'':tI~ .\",:,.,,:.:t> ~}~~:~ Address :~.. ~i t\:i-. .. f~~it:~. 200 nmps or less '.,~:r':'; ,:~)j2~1:.~~";"" '.~ .~~_?~.~~.' ,: -: ~ ~'''J. ~.~ !' -0;.~1 ~'l<::i ~.~1}t.... 201 amps to 400 amp;tt:'\'\'-1-;;-f)~':""~ .~:r$\7).OO ...'~~~ "'\::~~'..'~ ot 'i;s,~\;> 4~k:t}f_~ ~~1fC. 't'"~..,r:~'{.... ' ... ~o.l~ "<(f,-/ ' ...... ",.\,,,,~! t~~~~ City ~'!<':'- ':":"~!VhO e ~~i~~~:~.,. ~:.~t~~1~.",:. 401 amps t~..600 ~~}pfle~.:~t':t~~~:~';.". < ,:~~~2.5~q.R. . ;'~,;,:~ 1.~i1'~~ {;.t~,~ ~~~~t ~~~l~~:-r:........ ~;,~~'~~~60] amps to)OOO al11ps';'~J~~~~1 \ !""( ~~$1.63.00 '1..,.---" x ,:t'.'t:;.." .....,," JI~l'.:<: ..~. .J"<.. .f.\",.:~~.) h :;.l"~"t1~,:~:,~,';, ,.v,1......~~~"~~ " .~... -<:.:.."'~ '" .~ r--." "1.... ....- ~?:~t:( Supervisor License uinber ~~~t:f~ ,'''''7.l.~''.F&~~;::-{..:I~.~ f.;;r~O\'er 1000 amps/voltS.':;-~. )-:";~'1-l~~~' ~/~' }'~$3~75.00. - . ~;..."'~ ":~~A' ~~:l'-}--- \.;r '<'lt~-.. ~-.... ~~ ~~l;1'"' .v~... $l. .~_\.:. . ,., ....",'t-".. ~I~-",~".::> "-... . " .;-. ...~~. 0t-':;:';i%, 1'1<"f:'w"'~~'t?.;~ ::v:,"'t~..~;" ~ "':~';<~~i0:'^. ~~;,. ftt;;"'jYt'~;Reconneclonlv_t...;;". ~~~,~J.._..~'~"':.., .~,'~ $...;50.00 ..... i s"i;~'\;-.; ... .'...:1\......,*J':=-- "" nl~'t: :f;itw.;. ~ I''''''''' . r~:;;:'i.--'..("..-.....- ,,-.',..:',"~"'_ ~" ..t ~"_I~.'::'" ,4,---:. !t?~0 ExpiratiQnipate' ." ~:"". ~ ~~~t; i.'.{J..:~~:J. <~i~~ ~.~{~:~;V::.:~...~.:~,(~I~~:;"',;t.~ :'~~-:'ll... .'i~~" ~~..;~ ~" ~.~t.s:;:~.,;}';<:,.if.;\~~'~j,;i~:~ j ..~;r(j ,. ~~",'i,g"'!:.~P'f!.~'t.."\~' '"'J"~' ... - \' mtr..s "-~'t, ..' -... "':-~~ <<l't'.. ......::~...,."rt::'f.....~,,,--"')Co..:~ ....~....j;..,~.,..,.~-1.-l,.'.....;-;..J'f...,'..I::~ ~ ~ :1....;: (r~~,='i:~; r::r ;:'e;.,v.:ii':'-pl! ~'f>ft " ~i'\!i ~!'-'~:f,.J;,~1~f'~"~"~' ..~Tem]lornry Scn-:Jces or. Feeuers~.r-"\"'~ ~. t ';.,~':? ~:'I1 ~:~ ;tJ;.i':f.~'C.\ll~' ":-'il~t/- ~. ~'~"l ,~....... ~'I~ ~-...-~~tlt"'~~~~""'7.~/J:'t~, ~,'1#-.'v--. "...~~"I ".,~. ,~. ...t..~1l:'"t )..If-'!; ".8'~;.,;"~U:..I(,,,,",' ''H'~1' Constr. Contr.: umber~.',-' tj, ~ ,@.,?,';.""\~.~~ ~l~1~Installation, Altcration~'br Rclocation~~ ~ ";1; "!"i,~r:.~ :cE: r- [1:'<:: t;~~~~\ <....~~U:~;)~(!<;::E'-.-.~.:... 't:-~~ ..~5t~' ':f.'., ~...J",' :t"~:r~ ;:.~,(F' }.Z>', "'if ~':.t:f'~tt "'",,,,-!!.~?:'::':::t'!-7- .~... 'r;r-~'.~.:~~'ti-.l. '.1'''' ';, cJJ of.,r:-~~'?... .",..;.:).l'~-'!lr :..,'.1.. -;1:'",r:;~~ 7_1',,_ '4;~' ....H.._.:!.'{h".' :.-;;$.. ;t,..,~'}~ '.,;I-~ "'.' ;;..---;"I't.. ,~".,j '"l'~"r-...,~~.'j.)fl) .'4l..:\ty;~ .. .u.o.:.... """'''~'#:lfH''''~::...7 ~,. '"~:.-:,..:>t...~"'-'~/'.,l."'.... ,-;;..'~ '~.,,,,,~ ~, :.t/i,:............ ~r" ;,.)l..~~}"ilp.ExplralIo ate . . ,<-,;;O>,',."{\",\' 'W ;j',"'~,,'~~'-"",1200'aJ1lps or less -... ,c' ;", 1'~' ,h" " "$,0,00 '., ' :.. ;"'\\~"-:":''4:f'l. ''f, _'" \"~I~""''''~'<~~'-J~~...:t'~l:':).:'''2'0"1'' -I"" . . 4'00 .x~~ .'-.r I.'-'f' ....~...,. '. 1'1;'$~6' '9' 00 :. . {,>-;, \:t'l.:uQ:l':';':"':'''' . _i~.~l:.t'....')~..<.,--..'4<-:;'~i9_ .amps~to _ amps,A' .::..":2',')-:..:: \ . -..., . .... ,,' ?J~~~f,'Vi~~Sigh~'" rc of SUJlcn'ising Electri 'an ~~,~~:r:;'~-O~r,4bl to'66o-ifi1ps~~ :..f.~",:~u~~;::\ Vi:; 1':sloo.h:o. ~...~l~~ .~\'."'.-~'....'>f:j1,...:. ,.Q;'~!J.(,:l,}'l"" . " .... ,~,..,~...'" ..::l..:~Er"'.J,;\..t. '" ..\l'''I.?>}'~, r;~:}\\rt~~ ~ft,~,.j.; !;' "i,...t""'~"S~t...~h-- Over 600 amps or 1000 volts see '\ ~.4. '~{1""'~ ~;-,l.~:.lo {"~'~;',,~:;/1 "'~~ ....-~..!1::\.,' . - '^N'~. .,..'>t. ..... .._.~ ........':1,.. .....~ .; ..... {l.;" '/.!. ;(".~Yffi~;..;\{. ...:j\. """i..'f1'...T.4:x..:....::?:ti<.~). "Bu above .......~,,;'.?!..;..:. .l'.:.~.~.,~...,dc:r?J'.,,: :...1 ':1' ~,' . 0 . ,;).. t..~~""rv,""\\':':" ~'li::;... .... '... 'j -;..' " -' I ...,.y.~"~4,.,"\ '\''; _..-1'~j,'i.,;.{~"-~' l"',~ . .....l.~ ,'.',l--..~"'" <1),,- ~".H ~.~"\1ii~~... \..~' ."'~~:~d::- ... 'j~1..:.1,~.... ~'~~.;" _ tk\~ ~~'.~ ..' ~ ~ ~~'f$':.f5'" ~.ri": ;r~"*~-'.w;~,~,.. _ ..~... . . "'i""". ...l~'~.~.i...,. ,I '... \~,;:~;5,.~if;~~~~~~~~y7t...~iI~~..o, .,"~"..-~" A ::\;' ~ ~~D. Branch Circuits :'.:;::-'.~.~.\1~r~y~l:....~~. ';~';'~"I " ."'>......\"",,,./ ~i' '. .'~ :""",,0.,-1:-' , .1. tl'l)., ,.ft~; If .. . . .. ~ ." ',\\~.. ~"~'~i.'" I"-:i':; R~:~{'.J);Jl:;~O'!.l\I.ers }~~~c ~ '~'. '(,-r.f \.~. New~ljeratIon or ~xtenslOn Per, Pat1.el '. {i~..(~1'~~h:.,: '~'(':"<" ;:;'". "';'~',;s.,;},t."""':~::.rit..f.';~t1~- ~\~"'r\' liB: ~~M"" .,; '';~'\f\{', "~ls' ~., tt~.,)t,,(, !,~;',' .~.?.. ',,;.7: ,i~{t'{,~,", -1' :J::,#~ ~'~")il:~"',"" .~v :,...1.. I>:..~.: . .,..,~,. '..' ,~.~~ ! ~.'~ .,.1. }'-,\ ::.,'.',:' ~."~;... , . t~:f .. ");."-J,~i::'" Address' " . -' \.. ',~. ...~;>' ,,+ t . One CircUit. f. ,~. . I ':'~:. $43.00\..' . ~ ~i' ;.;,:;,~t:i.\\..:.:r>~~~.t""';-""'>'" 'f.~~IO&rilJ<'C' / ,:,,,:1;:,", ":;:; ,. ".;;:St._;i>, :,'i';' . ':.,":,~~~~/;,..~:~,C!:,','Cit~:'. .' '.' ,.".,, '".. ,-, Pho~t'..,., .',' L.ft.)l> E'ach.Add'itional Circuit or with sen:i~~, :':';" ,"', ' , _ .' . ,. ,...,: .' . . '.,' '.,.' . '" _,'.-:"...'.'. ,8"J~".~,,' or Feeder Permit ., . $ 3.00 .\ '. ,', '. OWNER INSTALLATIOi,d:';{' "r' ,. ---:-, . ':~The ;nstaliati~n is being Ilwdeon',;: E. Miscellaneous (Service/feeder not included) ,propeny I aim which is' not iutenchid, -Each installation for sale', lease or rent::" " ",,::';:;;": ' piul1p'or irrigation:. , :' ',,' Sign/Outline Lighting' OWl1cr~ Signature: Linlited EnergyfRes . Limited Energy/Comm $50,00 $50,00 $25.00 $45.00 890: mlf.lSlJ:J ' : 39NlJf.I:J gg'99~g $'G:O:J3~ lHlJ GOOG 9G 9nlJ:31lJO L~~0100~10;#SNlJ~l' ~ .' , .... Minimum Electric Permit Inspection Fcc;' $45.00 + snl'cWe, 4. SUBTOTAL OF ABOVE .t::{\ p:; 70/0 State Surcharge ~ S% Administrative Fcc 4. - f'Y) Sl_~ TOTAL , .. . f' '<~~'.'.'..: ~ ',..:,'" ..... , ' - ,.i. " .; ";.,' .' ".'