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HomeMy WebLinkAboutPermit Electrical 2006-11-3 LP2..., ':PAINJ~~~lg/~ ,:, lij. l'):\(l, .riS.rn '~~ ;'J -......"'...~t..;,~~ .,.~- 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-37S3 . FAX: (541)726-3689 "'",".,_. ,.. - --c' : . ~''''I~.~i.' ~,~, ELECTRICAL PERMIT APPliCATION . e:;;;:j ~:".:';,(;,. ~ " City Job Number CO~"l-OcE. - 00$11 Date {/),~E, 1. F't'OGA1'i6NJPJt;:iNSt;t'i';i'ATIj'jN-t.iji~{g}: 3. I.~O.6MPIlEi:E'EEFJSeHiIDbiE'BEto'w./';1~ti;~~~~. ,;.~l -..~'i.:.....ot...<o.rJ:" ,,"::::~~"'M.6..'...Q~ ".'~"', ~~C''''''''~''''''''''''"-~'~..rJ-~~'~:r.l~~!''' .,.... "-:.......'.:..J Lf3) AAi'_ ~.~T~ ~L _~~~\~.:'.~;, ~1'f:'if:b.f'Sl:'RINGFIELD, OREGON: '. ':.~ Permits are non-transferable and expire If work is not started withIn 180 days of Issuance or if work is Suspended for 180 days. i;ookritACiQidNsf;l:r.i;tTIO'NONilY'} 2. '._ ,t:.. _'" _" .~, "-:-.' _""'~'.' , t:C..:L:.:'~ OH' ..~.....'" l.'>>.l ,- "'-~~ .. - t-------' t Electrical Contractor U 200 Amps or less . . _ S 63.00 - 201 ~.to 4OO1,(iiijiS\\res YOU.:,:. S 75,00 llfEi\\l \U.w8:' "-k, 600l'A "'egOI1 Ut\.~,.., SI25.00 ~ Ie€> "C'V~I.!.. mps set- to'.'~W ~.u n 6OJI~inPsito'IOOO1j\MP.~:~ 952 '~n1 SI63.00 Phone I..fl/4J3~rJihC:9\~211~,,!,.!jl.90li\mp~oll.Pt the rul"" h, 'S375.00 In uA..-. Reconnect 0nlyJpleS 0 I he-I' S 50.00, .. 0090, You fTI<'y _':::.~. l!'lote: the te ep. " J.f7Lf.'r2 5 ca\linoc'h~~;.''''",,", s",..,,~.'~:r"Fh"d'~~~ ..~. .,.... . .... "._'~. Supervisor License Number ... . .'~ emporgr.v;; el'YlcQ!o~ ee<<,=rs~.l\~) ;,'. ;."...... ~1 -:..." ,',; ~'.~J't ')umber 10.' ". '1~OO:g3~'Zftlif. ,'-"'-'.- -' I () -I -D 7 Cj'D~ra;I\.1;o~, Alteration or Relocation . . i 200 Amps or less S 50.00 , Constr. Contr. Number ~ . 201 Amps to 400 Amps . S 69,00 40 I Amps to 600 Amps S 1 00,00 Expiration Date /;( /1.3 / 0C1 Over 600 Amps or 1000 Volts see "B" above, Signature ofSupeivising Electrician NO'," C fi~ ~.B;'an'cli"Ci~~i&~~\' , ~)..ff.il>~,;~fj-'J~~;'f!:,j.':!',..f It'. ~',' ",,':~;~".J r ~ '[HIS PER;.Jj ~U:~~~-;~;.r;;~;""~"-"".J' ' ,\,""~', <---fA j r: ~...,-- /j- ~\ ITHORI0\irdiIWi\ER ~1~nn~.II:~ FOr. S 43.00 . ( ~(~MME~~\litlOnA1lU1\'clU~I"WIlh Owners Name i2.v.. \....0 f-k-~-~. ~O~"t>~ Penmt S 3,00 ,. Address "3 '7 7:J' 1M tl" I' __ ~'>.- J E,l~t~c.cl,I3~~~~(S~i.€~!~~g.,',l&~~~~~.t~€~!WstallallOri J City 4u....~f!" Phone :>-:Jlf- tSTO Pumporirrigation S50,OO fr', Sign/Outline Lighting S 50.00 .~. Limited EnergylResidential S 25.00 Limited Energy/Commercial S 45.00 ,. LEGAL DESCRIPTION 170 Z. 'Jlf 3 t{ 0 J bOO JOB DESCRIPTION r4.....j f:?' t.J ttt f=.- Address a...~d. . City~ Expiration Date OWNER INSTALLATION The installation is bcing made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspeetlon Request: 726-3769 A. ~;;~~;rji~~~~C;;~~"gi~'~?1\,~Jt!:fh~iIY!Jl~~lll~g~ii~l~:i:J Service Indnded 1000 sq. ft. or less Each additional 500 sq. ft. or ponion thereof S106.00 lure 7b I t.{ $19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. ~~i;~~1;f~'!git~iit~~t!p'~,:.j,.~i!~~~~~1i~~~(o~(tjR'~-::;'] Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges ___..._ _ ...........~'o..........~.._'....,.-._. 11' " "'~;:','-"4'rJ..,.'."{.'~', ~ ""',1"';-'-' 1 ,. "";-",,....t' .r;1! 4. tSli.l:Hv.lAL'OEABOVE',.', ~:~, ;';""~'" I ,,;~.\.:,.,~,, :r~""j.~-':!n01',-.- ""~'~~~l~_.:,~j~d1',.i:">~~ 182 /1.{ sf:. 181.0 '7'0 jlo State Surcharge 10% Administrative Fee ",L.. Tt-ftLTt:"'" l~.- "Z 2"> rp- Shared Drive(T:)lBuilding Forms'El"trical Pennit Application I.oJ.doc