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HomeMy WebLinkAboutPermit Electrical 2005-7-15 rc~!rJ.:. :'."::-:t:ityof~hNGFIELD; OREGON ".,i( J:~' r} SPRINDF1ELD,.... ---, 1~~: ~" ~"'-J 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number Cj)--~(~ Date '1 - t 'i:~~/$" q ''''{J -"1'1 3. I:COMl'&-:ii-oFEESC-j;~~~fo{eC,W--::'::-; .- -;;::-, ,-.;.c_~- - -""--___~c__-"-.'e;I,.~If.- 8u6'>1~-- u_~____, 0"1 <ton - eQui Illeel" ._',',......'.,__:~ 'Aj~ ,.,_~. ,......,!f1{J. "._ __ ,'e s/Jec..iJStl,e" , . A.l~.':.~~esidentiai -0 'S'l~!~__ ti.F~ _': _ e: . _ Ilffi .- {~"'in~ wOn ~~ e Service Included "I(f~ ~ -0 lQQ.~, ~Rfgg\1l law leC\Ulle~~~lli\i\V~ . P..ti~~1:\H:(laaW!l!6~tPiftq~eg set lorth ~ .............. ~\lO~~~\~~hhose lules ~~ 3E':' nn1- $ 19.00--..... il!OtifIC~On &1&lPl6'rl?~gr ~ the lules bY ~ \n 0/>\ lwa9'l'l1JUllg1s;mJI~\R~ telephone $5000 0090i; g {he centel. lNote.. it Notlll""';.:r.. . ca\lIO~<:;li\eOreQen-UtJI "L:1JU:--- - ---- -. -- -. n\!ll}tslf~~~1.'ilf!'9SO'3-3JIstilf~tlilD, Alterations ~~elocatillD~__. 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 r--- -:- _..~--:--~ .-.-~'--_..- ----~-~-, ---""""':1 ~1~;;:;-sr;;:II~N.' -- LEGAL DESCRIPTION /70 'l. 3'11/ 07JOO J.lo'Mc, G\.drl,'\"h'O~ JOB DESCRIPTION A-~D c ( -I2.c..M.l. k 2- Permits are non-transferable and expire if work is ;. not started within 180 days of issuance or if work is Suspended for 180 days. '---. . .-' ~ --~_._--~ .-~ 2. : CONTRACTOR rNST~LATiON ONLY I / / Electrical Contractor Address City Phon~/ Supervisor License Num/ Expiration Date / / Constr. Contr.,Number EXPira,kte Sigrre of Supervising Electrician Owners Name (JU c.." c- (l '3' 'i c.o b.r 0 h Address (,,80 ( )/loseS f'i'S City 5,(rc'lI.,f,'e w.. Phone '1 t.{(, --76'1) . OWNER INST ALLA nON The installation is being made on propeny I own which is not intended for sale, lease or rent. Owners Signature: ~ (Lit ~YlI Inspection Reques . 726-3769 c. I Temporary S~rvices or'l'eedlir~____ Installation, Alteration or Relocation OR\<. 20~ A1]1p,s or less r:"nIRt Ir ,\-It ~,._$'S.o.OO \" Ill..... "" I <:'^' n~11 Iv \", 201 Amp~tg,~pOJi\riips. ,\-lIS Ptn _ ~ $ 69.00 lI0il'A;;,;;rto600 'AlRts\\ ClNt\) rv' '$100.00 ,11\ \-\U\\\Lt:V ~ "q IS i\\)i\\-\\) Over 600rAnipslor.lOOOrYolts see "B" abov~. "..11:\1\'''''-';:. ~m"\,\\v\;>..-. ---- D. \'Branch CIrcuItS ~ ~.t-''''''-'' ---- New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with \ Service or Feeder Permit $ 43.00 $ 3.00 _=-:-J /.(1.00 1.00 - -" .. _'H__ ------ --1 E. ! Miscellaneous (Service/feeder not included) ~Each Installation " . -., " ' ---- _._--.-- Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.: SUBtq-iALOF-~OvE--------l ," __ __.__ __ _0'__ 7% Stale Surcharge 10% Administrative Fee TOTAL w; '3ZZ l(bO '5 ] J'l Shared Drive(T:)lBuilding FonnslElectrical Permit Application 1-03.doc