HomeMy WebLinkAboutPermit Electrical 2005-12-12
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)7~6~
ELECTRICAL PERMIT APPLICATION
City Job Number (i f)fYlaoOS - ()Q)t;~
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Electrical Contractor H-414tV:1jk~ {J~{~~H~~R~~fIl:'HIS PERMIT IS NOT
r .' COMMENeEDrm\ tJSl"<BANOONEO FOR
Address ~'6't:::b ~ ~ "-f~ ~ ANY 18(f~t.~TOt!Amps
_ n 601 Amps to 1000 Amps
City ?or +-t~ Phone r;6?-2.DS_17~ Over 1000 AmpsNolts
. Reconnect Only
1.
. Tf9JWtlll4
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LEGAL DESCRIPTION
\'1 03 ~'Z.-- OD
C!2-ZDO
JOB DESCRIPTION
Vol'~ /D1T71f- CC/;t- u("dal(
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
Supervisor License Number
L-b -8Qr-CLE
Expiration Date
Expiration Date
~?bq9
2//5 J Ob
Constr, Contr, Number
Sign,rure of S111f;lff
v
Owners Name ~ QO.-\etUlcL\ \J\lt.tl Ptl{tN~
Address \\D N lA.,)M..../L-W Dy. .&.,;C 3-ot.{
City GI1, (A~D Phone
OWNER INST ALLA TION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Own'" Sigoa'""tJ.,JJ~ff:> ~~C\. \ ~
In'pedion Reque,', 726-3769 '!f\~
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Oate
P.,~~,~n7AcI ~fJnatul;)
I nlf"
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3.
A.
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
$ 63.00
$ 75,00
$125,00
$163,00
$375,00
$ 50.00
c.
Installation, Alteration or Relocation
200 Amps or less $ 50,00
201 Amps to 400 AcrfEs n law rf!ouires YC$1,~.OO
40Ip~mpN6160b\Am~~~ by the Oreqon lSti'6Woo
ovw\~ob~ Allie; ~d~,~~ ~01rs;seet.'iV6a '" '8 s:~;~~_~
D.
N\ Alt:' ti ,_~~,,,,,-,,,t~,i':1 Cnp,lJlvp I '-,'"
~'..i,_,~ria_ on or,i'~X~~nSlO!\;,,~r: ~~t!,e"~-~I~~~j;"O, 10
One C(jmiiit~, t',~<: Ce" .,~L ~. ~ -' \;",'" :("',.1.$(43"'00
Eac~r)\_Mitj9miICircUit, or \VftIV. .: ..:- _ (. J..')'
ServIce or Feeder- PemiIt I """ '-' '-' ' $ 3,00
... I ~ .. ..
E.
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50,00
$ 50,00
$ 25,00
$ 45.00
l.{6~
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
~ :3,-~
L{,~
~ 5;).05
1 ~8% S!ate Su~charge
10% Administrative Fee
TOTAL
Shared Dnve(T:)/Building Forms/Electrical Permit Application 1-06,doc