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HomeMy WebLinkAboutPermit Electrical 2006-3-23 C-C!..- '''<t~,,,,.;:r.c..\t-,,,,,w,,,,n..'''' -, , ' ." n. ., _"~'jI;'J",:.,~:itng~~~e~~~SSUbmil~J.;"'~~~ :,i\$;~~.:~ ;t;!;.,.~~>r€J(~~"'.'.. D.'. . '.. Ul< ,~J g.,~. Ii)'. t9 · '...i~li;t.~..,t~~i?J.<l~.ii},; s.' P.!;~~\'Wl.!;B!lCI1!Q,Ja.'. o.e.'ht'..ifIt\ ::.f.f~i~i"E~~!l'~t.~~'V~. . 'k~""",~,~,,:~~':'~~.,.,. . _ T/;:", ~'1!'"t;1,:.~~';!f:i~I.:U~ ~.-... ~oYI--- .J 225 FIFTH STREET. SPRlNGnELD,OR 97477 . PH:(54I)716-3753 . FAX: (~J~J26-36s9 9 - :J~:~;;:t.c "~:.,. ,: ELECTRlCALPUTr:'PLICATION . ,,(:;;:,,'''' I>~W'. ( _ AUlhor;zec~a.,bl.l1i"ti....... If'} I"""N' _ 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. ./\, o?' ';:)(" J...~n ')....~a \ A'B DESCRIPTION /~' 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 (SO ( n?--. 5.o{ (n.2>O ~~.31 Inspection Request: 726-3769 8% State Surcharge ~t~\ ~:~::ministratiVeFee 5~ d\\~\~ ~ Shnred Drive(T:YBuildins Forms/Electrical Pcnnit ApplieD-lion 1-06.doc