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Permit Electrical 2006-5-30
~~~i,~~ ill ,,!&"i S:~. . '. hj lL~.. .WN.....'.......". ....._ . .__~. .N'''''' "'''''"'''*''^t", -. >""., '. "'1-%%;:::~~" . . .n; >':;:1""'V:::-%:::;:::}..'::;.,.~ ....<. ':{ Dale 5/36/ 2.. au s.. ~..,/.. :":\"~:~"""" 'C[TY:0]:\,,-./RrNcrFIBj;ID"jNR'i~G"ON :.:',:': .':; ','" ~'<"'" ',,,,"''''~,,,,',.:;\,',,',, ".'~,,< ,~~~""",,,,':.,,,,:,,,,,,~~~~,~...j. '" 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-J753 . FAX: (541)726-3689 ELECTRICf}l- PER.IllIT APPliCATION CityJobNumb~Um~ -OOAI4- . t. iw\ ~:AL ~J1l01 74'f--k...- m- A. $;'N~t~~j~~Wt~I~~~1~~!~]~r~!~llli*j~!ID.~:~~il[#~M!~~t~~JR~rf)t~[~ \ I 0).. 3'1- '3 <:.f 03, 7b=6 ~~I~~~~I~~~~"""""""'''''''''''''''''''''' JOB DESCRIPTION 1000 sq. ft. or less $106.00 L \ 1'.. n Each additional 500 sq. ft. or 00 v(W 1tll\Q.. portiouthereof'~ $19.00 PermltJ are non-tran.te"':ble and expire ifwork is EachMBnufact'd Homeor'" ('" 'n 1-, not .tarted within 180 dlIy. ofiuuance or If work is Modular Dwelling Servi,?"or.. ," 0:. Ii' ~::-'$~OO' ,.. Suspended for 180 day.. Feeder '), ."". "/J', ~'~'~:J'O'~ 1. 1;1~~~i;ilijitiii:iiiI~,.i~illll! R i!~1!~~i~i~~~ii'~_~iill~~~i~1(~Jl 1'-;-, ./': rf rJ....U..rVI 'A/ ''',.' ~.It r . I.S Ot." ....007 E1ectricalContractor .J&LViYilfnl vn.TfQ/f!D 200 Amps or leis :~'the o;~ ({'.'Oln' "~'c' ,~~3~OQ/~~ ~ - '7' \ 201 Amps to 400<A:mps.'r is 7 f!on (/<;,,,$ -75:ll(b,.. y Address frt1 UJJ 'l~ IrVl (> kpf UlliK 401 Amps to 600 Amps -6UO-3.1') :!_ IV$ii5J,l9/~- ~. -v'-#i.J " J 4 601 Amps to 1000 Amps $163,00 City F.h.q R .YIL Phone 7<:6 -? 07 g Over 1000 AmpsIVollS $375.00 RI.-u__10nly $ 50,00 ~~q-~lE8..- /0,,-0 f-t} 8 ~~ 6 . 1-/~f)lp )( ctt/ ~F OwnersN-~ ,IM;J +' DeGvn~ Addressl g2fGOJr,1..Qm ~ City~~./ Pho"" 2i~~~ - OWNER INSTALLATION Supervisor License Number E.~l"~...":on Date Constr. Contr, Number The installation is being made on ...._......:/] own which is not intended for sale, lease or rent. Owners Signature: In.pectlon Request: 726-3769 c. f.~m~fP.p~t';~~~fi~~r'Wlt~;!fg0~1n]m0it11illi~it*;~r%.tJ~B%%1[~ In.tallation. Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps $ 50,00 $ 69,00 $100.00 D. ~~;_1J~;T€~1~;f{i%;1i;~m1:i:iif::@f:~~T:i~U%M~t~@@1W l,-....... >..;.,.:,,: ........,"'A:i;"'",,!1;""'''[i\4'',f'lFiP'Tiif'\'1K..'Yj...".....=w ., ."or' ,!t') , '",,--,... o. rvutil\ New ~Ite:,;,,~o,no~ E,x.te,.?'lon per P,~~,<! PERMIT IS NOT One Crrc)D~ ; ..t. ,,'eU Ofi IS .AR,~.,nl"l.$,43.00 R EachAddiii~I'Cin:uitor.withOD- -,,~u to Service or Feeder Penn it ' 1..1 II. S 3.00 Fn ~1~~tM~c~g!~!III!!!~I~~ll]i:~~.~~~f.il!l.~[~u[; Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50.00 Limited Energy/Residcntia1 / $ 25.00 Limited Energy/Commercial _ _ ~45,OO ~ Mln~.~m Electri~~~it In,pe~ee i'~hDrges dO' 4. !t~~~ig~$.!~!?!m~!Jt;~~0l~illltl~i!1Il!I)}i:;l~1 -</ s . cJO '3.(00 -<..) , .<:::;0 53. IdJ C)(5. UO 7% Stale Surcharge 10% Administrative Fee TOTAL Shared Drivc(T:YBuilding Fonns/EIcctric.:l1 Permit Application I-03.doc