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HomeMy WebLinkAboutPermit Electrical 2006-8-21 SP_P',ELD ZON \l'lil c.." ~~ INITIALS J.JM,' - 'DATE 0 , . ~~ SOURC~~~/~ 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:' ,~..' ..'.. ""-'~{,-d-~'--" 2n7S' O'f.,Mtr ' "2 ;:1orr7 ( l LEGAL DESCRIPTION: , ~,) \.A{~. IJ 170~2SY z. JOB DESCR;~ ' OltOO ilk -I.ov \r~{-M,~ 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 , . - -! ". ~, . ',' <\'" 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\. r ' ~-~ .-.,- -- ." ......"'. -' ,,- ".'1 -- -.'" - . 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 ~~~ r 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 o , '.' E, " Misc'ellail~ous (Service/feeder not included) _Each Installation .' -.- -..-- '-- , . ~ $ 3.00 . . .-~ -.-- 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 '-If l/r .' .. ~ . - ," 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 .