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HomeMy WebLinkAboutPermit Electrical 2003-4-21 . d". . ': ,'CITYOFsL.rnGFIELD;OREGON (') ,'J ,."."p ~ b 'tled hes the following 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FA:X;~jj~l)\l'llm~~ssUUi: specific land use loning and does no req ELECTRICAL ~ERMIT fPPLICATION . / / appro~al. (I.l City Job Number (0""'200;> - 6003b Date Iff I !Sf 0 J Zoning ~ , f Jf-v-o 3. COMPLETE FEESCHEDULE BELOW <::Kt0 A....monzed Signature I. LOCATION OF INSTALLA110N /3S U Cf(V;/J, <- LEGAL DESCRIPTION 170's Z 74 ( JOB DESCRIPTION . :~C~a e.<..-Jwtee - - I' .- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 06700 2. CONTRACTOR INSTALLATION ONLY A. New Residential- Single or Multi-Family per dwelling unil. Service Included 1000 sq. ft. or less Each additional 500 sq. fl. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder J lOb $106.00 $ 19.00 $50.00 B. Services or Feeders -Installation, Alterations or Relocation: Electrical Contractor ~"Vit:iIJ et.<<.Jtflt.,~,IC, Address ~y '11.~U City --.S!'.[.J Phone V7 .,e9 z. Supervisor License Number ;2/ 9 if .s Expiration Dale J ~ - 0 I - Z. (J d L Conslr. Contr. Number L I, 5/ <i Expiration Date ~. Z I . .if II) IJ " Signature of Supervising Electrician ~c:vz/'~ / C/ Owners Name H-o '^) ~c;. LJ Address I ",~b/J", ILk . ~r.rL"eW b, ~o ~ :> P r'l) Phone City 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 200 Amps or less 20 I Amps to 400 Amps 401 Amps 10 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 . $375.00 $ 50.00 C. Ten!p.orill~ ,Services or Feeders E WORK ~~~\\I'C' l' S\-\f\LL EXP\~E IF 1\-\ 01 Inst:i'JhitIo~Ulm~t'0D~ort\\e\i\'i\l!iQlERMI1 IS N 200 A'\b\1~9~~~E.D ~~ IS f\Bf\NDONED ~~.OO 201 AD\PtI~~Wj~~~ER\OD. $ 69.00 401 AJh~IJ~bb~ps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 3.00 e,qunes'10U.t? E. Miseell.neYr6{&~~~li~lII~oljV&~~tiBl.'I'h Installation AiTEN dopted by the re se\ IOrt,1 Pu~ro'1\CjWi~)llt6~oter. IhoSe rules ~ ~9!l,(llj)~ Si~~i&t\9tgl'OO~ 0 throUgll e; 'J'I~ A,O.oo bJ L. ". f':\A Q~ "d, """in COP"':>"'" ,(>"",,",,,,, ImllOO'B1e sa.,el!4J'U \~ 0 t"I"",,"D.u~' nna!\ U '\'lotl:!.' ",,, "'~O\, Limlrellal\rJl~~ererat~ \ on UW,\l>j NO"\4\)!UU Minimum E\~fJliitllle~li\i~fn'\f?h~~cf.~IH'4S?o"h Surcharges center IS 4. SUBTOTAL OF ABOVE /Db 7f.{L lObO ,7..<1oZ- $ 43.00 7% State Surcharge 10% Administrative Fee TOTAL Shared Drivc(T:)/Building Fonns/Eh:ctrical Pcnnit Application 1-03.doc