HomeMy WebLinkAboutPermit Electrical 2006-3-23
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225 FIFTH STREET. SPRlNGnELD,OR 97477 . PH:(54I)716-3753 . FAX: (~J~J26-36s9 9 - :J~:~;;:t.c "~:.,. ,:
ELECTRlCALPUTr:'PLICATION . ,,(:;;:,,'''' I>~W'.
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City Jab Numbe( "-\.1/ - (r"')-DlO Date -..;;'f" A~
\<?: 43Tlfr~~T~~ON P1WD 3. COMPLETE FEE SCHEDULE ~ELOWI
LEGAL DESCRIPTION ~. New Resldpntia.,- Single or Multi-Family per dwenlng unit.
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A'B DESCRIPTION
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Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof $ 19.00
ATTENTION: Oregoll IdW ""4uires you lU
Each Manuf1!9\:M~9J1l.;"olidopted by the Oregon Utility
Modular Dwelling service or
Feeder I~Ul"'''u['(J11 velller. Those rules ;$50.00t forth
In ()Afl9~2-.901-001 0 through OAR 952-001-
2. cONTRAC71~TALlA170N C?NLY B. ScrviccsrorIFeedei's~JlSfl\Ilailon;~teratihlis[orlRelo'.J1on:
(' t . calling the center. (Not : the telephone / .. Q ()()
Electrical Contractor _ Cf)(?.. .f).r.{)n('~n ~ 200 Amps orl~)er for the Ore['nn ' ltilitylf~JllMbatia!l...W":::> .
~nn"l_ "'.... "L 20IAmpsto400Anj'psnteris1-Rnn-11?-2~:7S}po
Address n"'N' 1'II ,,_ ~ 0 \4--L.. 401 Amps 10 600 Amps $125.00
o I " 601 Amps 10 1000 Amps $163.00
City 1'::" (t 0 .lA.1 Phone \~l.\\ )~~'OCiOS Over 1000 AmpsNolls $375.00
-" Reconnect Only S 50,00
$106.00
. / ~<.YlU
Permits are non-transfera I and expire If work Is
not started within 180 da f Issuance or If work is
Suspended for 180 days.
Supervisor License Number \ c:; lA..6 S
Expiratinn Date .lO.1 \ \ ~O,.,
Coostr. Contr. Number ~O. Q,.5 'Oc..,
Expiration Date "'\ \ \ \ ~01Q
Signature of Supervising Electrician
fi/;J)4~ 120
Owne~ame Q01h~ {ldCf\
,{~dre~CJ ~'I. ~\h' \
"0X1~~W_' Phone-
OWNER IN~~(3~1 ~
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 ^"'I'3rl\~: $ 50.00
~: ~1~~1!:SHALL E~~:.r.~J~.l~:~OF\~
!Ill 1 HUKILtlJ UNDER T, "" ,\., ",I~~~C',
Over ~u_PJd~lYRlf;'lJ~e~NOOnED FOR
D. Bra~~~H8~tMY PERIOD.
New Alteration or Extension Per Panel
One Circuit
n ll.. - Each Additional Circuit or with
\<:QlT (1;]L Service or Feeder Permit $ 3.00
E. Miscellaneous (Service/feeder nor included) -Ench fnstnJlarion
$ 43.00
The installation is being made on property I own which
is not intended for sale, lease o( rent.
Pump or irrigation $ 50,00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
Owners Signature:
4. SUBTOTjiL OF ABOVE
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5.o{
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Inspection Request: 726-3769
8% State Surcharge
~t~\ ~:~::ministratiVeFee
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Shnred Drive(T:YBuildins Forms/Electrical Pcnnit ApplieD-lion 1-06.doc