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Permit Electrical 2005-6-10
Date ;:f,::' ;:. ';,<GlTY:OF.'SPRrNGFfELOOREGON'" '\- .J .,J : . . ,,;.).. '~'. ", ,~", ~',. ".". J," ;1. ' . 2251"" n STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)72603689 ELECTRICAL PERMIT APPliCATION, City Job Number ('tJM.1..O 05-00z..q~. .t....' ~~' ~. .. , to / a....( OS ~~,6~~ ('0' I '~~'?p . .~'~. 1. ri':oaiTi()NitiF:.ifNSt.M:ifAJiioNf;.:.~..~~t';ci 3. ~rCOMPr5EFE'FEE'S:' ""'. IBl)" "'~;?:~,,:':lil,,~W;';6 , .~.......... ,,'~ "~,,.~__...~.._.,.___~_.,..J~'c~ b~~~..,._..<._.._.._..~~~~l!~~_~,... ..Ip." :';"."'("'~ .,'''1,<1,.-- ()~UJAJA t\.or~ ~ '\',;',0. '\). -:I' \Ol>lP ~""",v'\.."..oo./ '\, d~ <::-f'O. --. -- -- -- .'" -- -- . ! ~!.l ;rN' ...,uiR"';o'i1'=.:l""~~S'~""""'''''~M'..' 'c~'--''''i<>'''-'''''''d'.~'I'I'''' "'I"""J' '" . '.r ew. est en..un- lD e,Oc.' tFJramu~, er. we 1D .un ",!", LE\~()~m~N \()1CV ~\(yP/ ;~;c:~~u~:;..~--gI.,-~~~).vr YL..~.L_~", JOB DESCRIPTION ~ 1000 sq. ft. or less v' Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modnlar,ovrelling Service or . $5.0.00 'J 1\\'; \ I"'.... nlnf"'" Ie TUE . . '\ FeedrfHIS PERil11T SHALL EX:.:: .;:, q,." ~";, B. [kfse.~'~if~fJ;~~~~~,f~l~;~iI~ti6fiJAit.~liiiif;;~~;;';R~IO'e'a'ii~~'::\ ~j ,~"'--"'l-~""""">-"'.'l:I'~..~... .".&I""'1''JW:-'';.''::o:''~~~Y''''''- .. .,- :.1t"".:'l> 1 , ~ ,JLt1l-,o~ ,.", <,,,,',,: .0'"' ,.!} L\..JI~:..ILr\'ui....U VII ,.... . .-.. 200 A.'!'P.s,'or lesslJl\Y PC\-~IUJ, 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsIV oils Reconnect Only Low Vo~_~~ 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.....~~ .....:.,....~":'"~'-'.:.... a.. ~._<,,' ~"'''' .."..,..-..r... ',' _'. _'.'"'-' ...~ !.,'-"" "":"-~>.:"'~ 't!CO .' 'eT.OR.INSTALLilTLON;ONLY,' 2. ;, '-lo"~_'j~',,,,;,,,,-~___,~.,:, ....-~)...j,.,",._;......-.'.. .'," -, . . ....-- -.. '_.~~.,. Elec1rical Contractor ~m~b8 Address ~(') \In,, t.jo.&ii/R City F.rl~ Q1t.Jril/ Ph~ne 1/81./-0/11/1 Supervisor License Number8P,Q:gLf: A Expiration Date lol,/as Constr. Contr. Number 11./ L/ If) ft&1 . Expiration Date Owners Name ~ ~-f:t-leY Address l"gft, O~ll' ~ -Ave... City St'Yl~G-ltA Phone ?4--'l.-?';cz,o OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 10spectloD Request: 726-3769 $106.00 $19.00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C N;Tt''':~''';:''''';:/''";~'':-C':': -41,;;: ,i. i,.;..'..;;;F....~-!l\._~O$.'- .,-, _1 .~. (ol";"" '~ " ".'~ - " ~:l' ' .. ..; """l "'J . 1..;..'.elgpo_..,ry.~~.~:~r~,;,t;~e_rs.::.'~1iiL~.:\,.I5, 'i'{.~. "_~. .'_'f...~:.;'.',~\ \1".. _/\11 :-: I (). l~r'"':' lIN rpr..irrE" y.,. ~') ~!l~,a~?'C Alterat!~n ~r,Re!~c~J1~~Jcn Lltility 1\~<\9.~!!lP~R1'<!,e~Mer. Tnose rul"~ .>C" oot ~j,qi90 irfQ.I!MnP!,~@Q>wp~ through nAQ Q,,?$J~'OO GtOJ~~tp,@p ~~n copies nf th" " d.,!19lfOO ove;/i;oo A'mp&Iifl\ 000 &blis'set,'1'!BW~\jlivlone D. ~.6(€(r~!lP~()W~V!!'Y,!.lI,Otill:llf!Pf!l'! \(~ .,i?~. :::;,;; .: ;,1 ",t!llLer I~ '-OUU-.:I""-";,44}. . New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Pennit $ 3,00 E. t' ;Mik';;lia'~~iisi(s:riol~eif~l',i;jl';{i';~I';c1edj:!'.E~~'ii'~riiii.lb'ti~'n ,;1 -.'''''''''-''- .~,_ _."....;........ .,- It.,>_,- .~... ~'.'.. ',' ....',;,:;r' '.C:" c. .t.,'........ '"\.,~..,,,..~,'.. "...--..,,,..1 Pwnp or irrigation $ 50.00 SignfOutline Lighting $ 50.00 Limited EnergylResidential l $ 25.00 ZS. 00 Limited EnergylCommercial $ 45,00 MInimum Electric Permit Inspection Fee Is $45.00 + Surcbarges ~;".I"~~,~ ';.0/..\..... '.':-:'~'":"." ,;';"'/'Y~"'.. 4.qSli.H v.AL;OF,ABOVE ;,'.,<.l."~'I..... "",~''';'''.,<~~.;.:,~''' '. ':::'''-\~'-:-(-"~~~ -~, ..' 11' '5~'.~:~j~'~~~~tJ..~.. 45.00 :3.15' 4.';0 1?Z. fn 7% State Surcharge 10% Administrative Fee TOTAL Shared Drivc(T:)fBuilding Fol'TTl3lElcctriclll Permit Application I~03,doc