HomeMy WebLinkAboutPermit Electrical 2005-4-11
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (941)~726-3689
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ELECTRIC;ua:~ ~'PLlCATION 10.0,;",9. ~o"""
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CIty Job Number (. ,... Date () . '0'0 %
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1. r:LOCATIO!(rR-F'lNST.' .TION~:"-;ifi;i:~;;( 3. ~,COMPmE'J!i'J1.l'." ULE 'j>;OW"~"'::.:t'.('(",",'>';"':';'''R''>,"
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LEGAL DESCRIPTIO' N A. ~'N~f{Jf:;r:;~~1i1ft'fu;~"~f:'~j'r~i-.' ';11~~tt~itg~{;t.;;t,t.':II'
JO~~r')~E~Pc:; 'L;i~\ \OlCXJ ~~~~:';:C~:~:~S-~~--~'''''''';::''''~'$~~.Vo':0:4;~;~J>''''~'-~
Each additional 500 sq. ft. or
portion thereof
Pump or irrigation $ 50,00
NO .Sign/Outline Lighting $ 50.00
neE.Limited EnergylResidential $ 25.00
THISPERMIT'<:~IE"I r'I",.._._ -'31 $4'00
The installation is being made on property I own which UTHO Llmltea nergy''''OJll!!1xrcl, IE we'''' ),
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IS not mten e lor sa e, ease or rent. COMMlnimum 'Electric Permit Inspectib'D 'le-ells $45.00 + Surcharges
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ANY 1 p.Q\p.1V"~ ~ ,fJl!>!-l'!t'''-''_r.1Cfuii', cfl. - .A I
II. !.~u1J:L:.@.TcAL,Ol:?1BOVE~ \; '''-~ 'C,' -.: "~I ; "t1 fl
1~7~:';::~'S~~~:~;:' ,...,.:,. - _1~.;~ ,'? :5.02-
10% Administrative Fee i. . I EO.
TOTAL bf~
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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Electrical Contractor
Address 0>1,1,~ 011/ao-@ 6+
City ~(l.J
Phone . idJJ - 3l/:Y7
Supervisor License Number Lfg7 9 S
Expiration D, I D J e rj :;z, 007 as
Constr. Contr, Number /(/qsOq
Expiration Date It J 0 ~ / ~O.;--
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Signature of Supervising Electrician
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OWNER INSTALLATION
Owners Signature:
Inspection Request: 726,3769
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Each Manufact'd Home or
Modular Dwelling Service or $50,00
Feeder
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u..,,-ltlQ9Al'P!l!;~ s'. Ose ru'e~ g_. . $'~, ,00
c.n:m~attn~ 3~Q.\M~ thro~gh OAR-g5;.f~~.00
4nlliM!Y~I~ ~~O ~t P COpIes OfJ"" "t',~.?J>.'rs.oo
~e-n er.~Not . th ...il)v
wroanps'~ WS<o}m ~n e... e te/eOhn'llrf r63 ,00
Over lO~top~l'_ ~/ty Not;ficatjn~375,OO
Reconnect Only '2344l.'$ 50.00
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C. I,:Temp'orarY-iSenflces ortF:eederSI~'~;:;l,':- ". $ :-\.<0.1 ~"., ~.~;_ .~'.'~ :' ,~~,
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lnstaUation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
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$ 50.00
$ 69.00
$100.00
New Alteration or Extension Per panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3,00
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Shared Drive(T:)!Building Fonus/Electrical Pennit Application l-03.doc