HomeMy WebLinkAboutPermit Electrical 2005-10-18
~~~i~V~'.~~~d.dL::1)~e 5V.V"~\Ci} _
nln~"'~,' "
~~'~f-l'''3
225 I'll' In STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54I)72"6!Jli89 ~F'Q~ .
ELECTRICAL PERMIT APPliCATION ~"\I.Q"""O Slg,'t ,,'. '.-.~ "
City Job Number c.ool1lPos--o/oS"l Date \()-\l-Cfj
CITY 01. S .INGI'I!.!.!),ORI:GU[\i .
l. I LOCA'l10N OF INSTALLA'l10N
C[C1 0 ~\c\ ()('(' \""o.('~
LEGAL DESCRIPTION
nD 3 ZJ lfL(
3. I COMPLETE FEE SCHEDULE BEWW
A. I New Residential- Single or Mnlti-Family per dwelling unit.
Service Included
1000 sq. ft. orless
Each additional 500 sq, ft. or
ponion thereof
072c)O
JOB DESCRIPTION
{l..b''',^~ ~Q{, \\€.-L0 ~vv\,\,\ (,OOlv)
Permits are non-transferable and e:lpire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
2. I CONTRACTOR INSTALLA'l10N ONLY I B. I Services or Feede.n,:: Ip~W1atlon, Alterations or Relocation:
no 'li'9.on laW reQU" v- ~ U\ili\,!
':r;E.NiIONloorritePf\9f t~ Orego set lor\n
1011~W lules ~m:;"'~9s4POXliip~;: 952 ,00"
, n r.l'ill\l~.r;..::': ,h (l~" t
llatilica\\O '<IU{.OO'ttl t"'\600~~~\\'\e rule; J'/
In O,t>.R 95Z-~~ &mP'~O;'I'611~~p.~\ep\1one
Phone 687.5770 (\090. :ou ~rlAAO ~~~tsNO\\\lCa\\on
calling t. 'R'tiWl~qn1YU\\ i344).
l\Umber lor \?;" ,.800.332.
~1' "'~ioporary Services or Feeden
Electrical Contractor
ill Electric. Inc.
$ 63.00
$ 75,00
$125.00
$163.00
$375.00
$ 50.00
Address
4685 Isabelle Street
City
EURene
Supervisor License Number
3782-S
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D. I Branch Clrcnits
Expiration Date 10/1/07
$ 50.00
$ 69.00
$100.00
Constr. Contr, Number
37587C
Expiration Date 7/1/06
(CCB 104929 3/14/08)
Signature
New Alteration or E:ltension Per Panel
One Circuit \
Each Additional Circuit or with 3
Service or Feeder Permit
1(,Q 00
$ 43.00 -. 1,
1ln. 0<>
$ 3.00 I.
owners~me 0-hfL.., (~~~6dcW'
Address '7 ~O ole! Orc..L.."IA.J
City <;, \> r'- Phone 73 b - 5'61.( g
E. I Miscellaneous (Servicelfeeder not inclnded) -Each Installation I
$ 50.00
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
.
.
"
Inspection Request: 726-3769