HomeMy WebLinkAboutPermit Electrical 2006-8-21
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~~ INITIALS J.JM,'
- 'DATE 0
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8-2(-Ob
'225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726.3689
ELECTRICAL PERMIT APPLICATION
City Job Number COo4'\Lo<,::> b - 00 ~ z. Cf
I. LOCATIONOFINS,TALLA'TION:'
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LEGAL DESCRIPTION: ,
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JOB DESCR;~ ' OltOO
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
Date
, '.
3, 'ICOMP!:PE FEE SCHEDULE ~~L.OW
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A. New Resi?ential.__,S~n~l: ~r .Mu,lti:Fa~ni2', p<:r d2"ellin~ unit. ,
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
$106,00
$ 19,00
$50,00
f .--- -- ~..~ ..
2. .CONTJ!.,4CTOR INSTALLAT!ON ONLY:. B, ' Services pI' Feeders ~ Installation" Alterations or Relncotion:
Ele~t~cal~:=~or~' '~~~I-' .....' '" , 2~~ :~~:':~~~'~~d~~~~nb~::~~~~~~~f~~~~~
P:?!Sl7J~ N ,1lt:D' ',I 1!/ 201 Xnr~fi(K4.00rA1J1Pster. Thos/> r"I,,~ '';e.$s12r9Hrtr.
Address ~,.t:I JO'2.-Sl.uy9' ,0401 Ampltb1600?A"mjio;,0010throuoh nAR~!:72,9~1.
, , ' 601 A%lWl\> 1[odoTA'tllp'Sbtain copies of theS163;00iY
City, ~/'JI'" /..,,&1_ Phone (~1JI) 7?{, ,Cj;(')t Over 106ol.!\'rirp~Yvo~nter, (Nole: the tele$3a5:00
~. " RecoruDW"'dtiIY for the Oregon Ullllly Noti$r50.QOI
Center is 1-800.332-2344\.
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c. 'TemPo.2':2'.Se!yices?,: ~e~~ers . ."
Supervisor License Number LE/5 Z 7f3 '1
Expiration Date (d- rf!?
Constr. Contr, Number
1')LIYiJ
Expirarion Date ?--Ir?-(J 7
, I
Signature of Supervising Electrician
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Owners Name S:-, it-- ''J'
Address /?o Ro~ ,reg 7
~b~ePhone b'{b-S3Z0
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
Installation, Alteration or Relocation
200 Amps or less $ 50,00
201 Amps to 400 Amps _.. $ 69.00
401 Amps to 600 Amps X. W "iflx. \N\J~~ $100.00
~01\'Qver ~~~, ~P.~'or~~~~a!t,",'~'ei:.t~'\,';~e.
WR,' ~lB1l~~_\9,if~tli\s~i3f>..~QO~x.Q .r ,_.
'lJi~r.}~~A1tefan8n ~r\Extension Per Panel
,.... '''~t "v~- C?,\v\.I,
cotone ,i'i5~,i 1''- . . $ 43,00
f>..~E"l:~'Additional Circuit or with
Service or Feeder Permit
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, '.'
E, " Misc'ellail~ous (Service/feeder not included) _Each Installation
.' -.- -..-- '-- , .
~
$ 3.00
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.
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Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50,00
Limited Energy/Residential $ 25,00
Limited Energy/Commercial / $ 45.00
Miniruum Electric Permit Inspection Fee is $45,00 + Surcharges
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4. SUBTOTAL OF ABOVE
- .'~-" .' --- ,,---,
.:."-
8% State Surcharge
I 0% Administrative Fee
5% Technology Fee
l(~g
zn'
SS3~
TOTAL
Shared Drive(T:)lBuilding Fonns/Electrical Pt.."1ll1it Application 8..()6.doc .