HomeMy WebLinkAboutPermit Electrical 2005-7-29
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 lk ~\ .'1' .';
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1. ...L'OCATIONOFINSTALLATION. .' '.. 3. "'COMPLETEFEE.c;dif/J>vlJLE LO ,I
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17~3E2,i{(N I S~C> 0 A'~;::~e::::::::aI7~i~~~~~:;oJ~g~~i!tP~~~e~lin~~nil. J
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JOB DESCRIPTION J1 1000 sq. ft. or less
A I ..A. ,,"v' +- Each additional 500 sq. ft. or
C b ~ - 5:0" C ( (L(.J..A.. -; portion thereof
-
~;:~:o~,!f"~' \ .....,'CIIY Of S~hNGFIELD':'OREGbN. ',' }l'l'" - ,:'
~l.., .T , . '"'.~', _ , . Si . ,
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C. , Temporary Se~vices 9r,Feede;';-'
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, ":'\:' _""'(<~ W "(\-It INU,~~
':\ \~ ~ .~.. "~ Su' \..\"InstallatioIl"A1teration or Relocation
, ..~,f. 1 \\t"\ IS t'tt\\\Hl\ ,-
"(\'\1';) \'(.~:I"~D' IjN\)t\20O\m"~lofiles~OR
'-'0,,\ (. "l~Nuu"'-~
fi-Ij'\ \I "~CD DR 1'3201 Amps to 400 Amps
COl'l,\,\(.IW~,~ ptRlt;!i}[. Amps to 600 Amps
f'..N'< \BCl D....
Over 600 Amps or 1000 Volts see "B" above.
rR.:--'---'-'--- -. -------,--~
D. 1 Bra~chCircuits ___.~__ ~~.__;
New Alteration or Extension Per Panel /
One Circuit $ 43.00 l( J'
Each Additional Circuit or with
Service or Feeder Permit
, Permits are non-transferable and expire if work is
/' not started within 180 days of issuall$~QI:liV\vork is
Suspended for 180 days. . leo.u\1 0(1 \)\I\\~~
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2. ~~I\B ~oo";' \no'~o~\\O~ IU\e'S"O'I.J
Elclthical m)~ot.el. .J'l ,nloug ~ n\ \ne .-,",0(10
\0\10" \10(1 '\-()Il'': CO?,V- e\e1o\-'. r'o"
d'~\I\IC~ 9":J~'()() O'O\~I(I ~IO\e'. ~ ~O\I\I~
A ~p..~ ~,,'l " l\' . ,,"'II\'{ ....l.'
\(1 ,,'10" . cell'~ ,,0" - ".Z7~'1
()()9v' \ne Ole", ~~..
City C~\\I(I~, \01 \n~ Ie, \ Ph~ne
(lUl"" (,e(l\""
Expiration Date
Signatu of Supervising Electrician
r..-> . ~ '~\ Il ~ 1l
Owners Name .,,....\\\ 'ff (~ u)O-
('Address _/7 c~ t1. 0 '~..,.... S
9ty .5fh~~/j) (Phone 711l- 17-L)r
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
. Owners Signatur~ ~~ ,--)
"" a ~-;- c....." ~
ty ./
Inspec~ Request: 726-3769
$106.00
$ 19.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B. I.S.~rvicesor Fe~d~rs'- In;t~lIatio!" 'Alter~tions or !~I~~~~-: .-:
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50,00
$ 50.00
$ 69.00
$100,00
$ 3.00
-.-------'1
E. ! Miscellaneous (Seryice/feeder not included) -Each InstallatiOl'J
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50,00
$ 50.00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fe~ Surcharges
4. ~lJBtq.iAL OFAlJOVE. - . ,--l 'I S
L. __c__ _~-- --'
7% State Surcharge 3' :>-
u ,-0
10% Administrative Fee " >
5 E,)
z-
TOTAL
Shared Drive(T:YBuilding FonnsJElectriClll Pennit Applica.tion 1"()3.doc