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HomeMy WebLinkAboutPermit Electrical 2003-8-15 ^,. _ CITY OF S JNGFIELD, OREdoN _ . - ~ I 1~1I~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-M&1las submi \edl18S e ELECTRICAL PERMIT APPLICATION ThelolloW~~gJoas not ,aqutra ~ <::::I'{ I zon.ng. a 0 ~ 5 City Job Number ~ 2C03. (X)5rf.J. Date t7 ~ Q3 approval. . .JS /0 1. LOCATJONOFINSTALLATJON>' 'j 3. ~OJl1P~ETEFE~~.9!f~:'~~:ELOW ,,-'- ~ 1/ cc... O~. , S' na\ure- tf\ I ~ '. ./ A ~ p.u\hOflzed '9 LEGAL DESCRIPTION A. New Residential- Single or Multi-Family per dwelling unit. 17032\'17 0/200 E. Miscellaneous (Service/feede,' not inclnded) -Each Installation \\1U1ICE: ^ .~. PIQE IF THE WORK :;UI<; PERM~~b~~\' tidh'PFRMIT IS NC:; $ 50.00 AUTHORIZESlg\Jlliil1figet:l~tlnl$ FOR $ 50.00 OWNER INST ALLA TION COMMENCEUoGcfu \5,[}~~Rf!~~P.l $ 25.00 The installation is being made on property I own whi&"IY 180 oe.'fnfl&PiQRgY/Commercial $ 45.00 is not intended for sale, lease or rent. Minimum Eiectric Permit Inspection Fee is $45.00 + Surcharges JOB DESCRIPTION ~TT Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. ,CONTRAcTOR INSTAL~TION OlV~y Electrical Contractor :)' B' aF..-ruG Address Le~~5 T5Ir8~~ rJ!. fHo'2-- City WGf1A)f5. Phone ~?} -51- ~o !uJrv~?1/2Nu~,!lj@, ~ 1-2,5 I of J /0</ . I , I E> L{ 92 9 ~( ILl ( 0-/' Expiration Date Constr. Contr. Number Expiration Date Signatureof(yX~ / ~1t:7" ~\( ll<'" I Owners Name ~ Q~ Address 21 '" 7 01, ......'7. ~ I City s?/-"b Phone Owners Signature: Inspection Request: 726-3769 Service Inclnded 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufacf d Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B_ Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only -2- l).-~ .~ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. A;i~i!.'ROr!L11\~~~!c..~oniFeed~f~JlreS yOU. ~o follow rules adopted by the Oregon Utility. NJmre!Wi'!~(.>\!!~r<y~jo''"~.!'~lteiocatlol1re set fort . 'n2.99\~P}~ot\less.001 0 through OAR 952$''5'0.00 oGg!J~n1ps ttl~4QO(Kmp~n copies 01 me rul~~~.oo 4Q,I1i\:mgstiO!600ll\ifips (Note: the tolapno~I-oO.OO ()lImNv 'n. thA n'.E!!:lon1 Utility, ~Oll1lcallon ver-MJU A:mps or lOUO-Vatts.&ee B': above. D B Cl'!nter is .1-801 -\j'-1:.!-2;j<l"'., . ' . rancu ClrcUll~ ""'. . " New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 ~[2 $ 3.00 1-U>.oD 4. SUBTOTAL OF.ABOVE J. Lf (p .00 (1.1.- ')...- d4.<oo d, ~1.'t)-. 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)JBuilding Fonns/Electric.lI Pennil Application I-OJ.doc