HomeMy WebLinkAboutPermit Electrical 2003-5-28
3.
~ . ~ . CITY OF S.. ~aNGFIELD, OREGON '~.". ..
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ~.(x):\OS Date
B. I Services or Feeders - hlSta~tion. Alterations or Rdoeation:
~'V '"
200 Amps or less ",\~Y... S ~<;) $ 63.0q
201 Amps to 4~~~~'\ '\ ~~ $ 75.00
401 AmPt~~~~~Y...<;)' $125.00
. 6014h'~~~q",~~s $163.00
Phone ~,,\\CV1(;~i.~~pm;Olts $375.00
~ s ~':.~'e-;~\$es'M~~. $ 50.00
C::'\~" ;\~'V~J",f~ \ O~
Supervisor License Number 'd:3)7 f) - V ~'0 ,",~~1;,~~orary Services or Feeders
~" " ,\I
/ ()/C' (j' ~~ Installation, Alteration or Relocation
Constr. Contr. Nnmber /Od-.3/b
/0/ d2.,
~o
;;rmits ~ non-tr
not started within I days of issuance or if work is
Snspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY I
Electrical Contractor
Address
L YNN'S ELECTRIC
PO BOX A 726-7895
~L.L-''''oCE:'V r\n :-13:
City
Expiration Date
Expiration Date
,
-
Signature of Supervising Electrician
~
e 6~~ ~,,'b .'-
Address 30'1- \A\l')(). Qa t\) J!'2-
City ~ n<L PhW .1i.o'3. rcrd
OWNER INSTALLATION
The installation is being made on property lawn which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Reqnest: 726-3769
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
I
It)lo .rj)
3KoU
\
~
$106.00
$ 19.00
$50.00
$ 50.00
\$ 69.00
"..,,,
401 Amps to 600 Amps .,,_ ,\$100.00
~.......... IU" " ...
Over 600 Amps or 1000 Yolt<'see. ,B:tabove;" .."
D. I Branch Cin;uits
.;." ,t\Ulr. ".\1'-" ,'\ .....'\\'1"
New Altei'atioli.or Extension.Per P\'nel, ...... .r\\''':
,-'., ...\v' .,_\\'-~ .'P\'." _ '-", r-("'\I . \\
One.ClrcUlt U" t.; 1.1'',") \ . ,r~" ". ._".r~ $43.00"
,,- \\ '\' ," . "I'"~
Each Additiona1ICircuit'br~wi'th,l ,\:,:. -','..,. ....'c"- .
Se~i(;~or:'F~~4'?tPe~Jt~,\::~. \~:"'~.' ( \':' "_" .1\$,3.00
\.' _;",,''t.' ,:\""1 \. f"'.\.... -" I'.:..,.
E.I MiseellaneOlis (Sel"YiceJfeeder not inclnded) -Each Installation I
,\\\~\'~ C':' ,.-
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
200 Amps or less
201 Amps to 400 Amps
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Snreharges
I \L\4.o0
\(\.O~
\4 _ "\.n
\ (~6 4P)
4.1 SUBTOTAL OF ABOVE
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding FormslElectrical Permit Application 1~3.doc