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HomeMy WebLinkAboutPermit Electrical 2010-7-15 ----.-:i] 'ON ~ r.ii.:: !NITl S ~. DATE ~ SOURCE . ~~r- Date 6 - 2:-/- ?P/O , CITY OF SPRINGFIELD, OREGON 225 FIITII STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number U:JM Z-tJ/O-()CJ71/ I. ~~rQiYrQ.f!&~r~ffo;&;;;:i:"tSl:5i /7() 7, z../~t 71: Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D "'B:.:_,.t.;"ii'c.'~,K~ti'5"~~i'~i.m<:'~';;~'t:'l~~~~~~~~1 Sign~ture of Supervising Electrician . '.ranc . .'rcul ,., '.;.".'-,,,.~::, c'.;, ,." ~,'-." ".' W . '.'.. .J 7 ' II} New Alteration or Extension Per Panel f~ A/V1~.) ~.v~A One Circuit $50.00 Each Additional Circuit or with :?- ' (".tJtJ J y') .cO () .-.r 1_ _ _ Service or Feeder Permit $~ .~ Owners Name ~O Address \) C) ~'f W E'~M'ii~~I!i~<i~~il~etv@f~i<l""~"~~ti.\~IU~t~r",I!;\iFti:!~ttiU~ City ~~ Phone Pump or irrigation $ 57.00 ~ Sign/Outline Lighting $ 57.00 OWNER INSTALLATION ~ Limited EnergylResidential $ 29.00 The installation is being made on property I own whic Limited Energy/Commercial $ 52.00 is not intended for sale, lease or rent. Minimum Electric Permit InsPection Fee is $52.00 + Surcharges '. ~,,\D .to..f SUBTOTAEOE"ABOVE i.~'';'~ '!!fi!'~ Owners SIgnature. W'" ~\l' *'<'''-.1''- "-# "'Hl'=, "~,,.',","l4~k, it; ',,, l.{./ .)~O< 12% State Surcharge . vJ 10% Administrative Fee ---.1. 5% Technology Fee ----..::J". toe) -.lDB .5 ( ~~~~~~~~~""'''-'~~&d;~~ LEGAL DESCRIPTION: 17 b 7 %/1 US-VIt)O JOB DESCRIPTION: uo"f- 7erill~ fCf~,h ,t;.-- jJY'Of't'Jtte bffl"-115t:V",f- C19I1+..""-b.... 80'- #tL-S I'w""';II Permits are non-transferable aud expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ';6\- '",' , -. ....w..< ~"j.,/~ ,M.:.J!, " _. "' .;,,;';; r- /" ",1W,P, "".._"0,,,;1,,._,1'1. '-, ;'" ,..;;AVL,,>,! .OONTKACTORlJIVSTAEl:A1.10NiONLl:t 2. ~"~'" _. - ~"'C7 '..;., f,,'.." ~ .. '. '".">', ._, " ~." "' ,,,",,, .. ,'~',~, . :t-"..... ~" ";::". ,. ", .'. ,'" Electrical Contractor OREGON ELECTRIC SERVICE PO BOX ??~7 E""r.~1t: f\1) 97A02 V\.l~,:~, V~ \ 'I Phone ~I..\.::, - II::. 'i:;\ Address City, Supervisor License Number ,~q,;;".s Expiration Date 10-/-('0 Constr. Contr. Number ~ L/D'i( 11~lq(n , Expiration Date ) -( - II / , S-C1-/o Inspection Request: 726-3769 , ., .. ",' ,,-,-, "'. .""" ~., . ~",,^ " ...'.-'., ='~'",.''''''''' "''''''',' '"'-~," . '''''''''''. "'111!>..i'I''':'i'!i#r. " :,J/,:",.",. 'J,-:,->,-:,+;j ~lj{'.j 3. :JCOMPLETEFEESCHEDUIill'BELOWW~'! ,'i,".iri ",~'i.;i"i'~' ,. .' ...' .. ... ...-'", _.. " ,-_ . ,_" ... ,_ "'." :" ,', ,r.- "", ..~,'. "I_1~ .. '..:it .~ A."~e\V~R~iiI~ritmi(+~$.ihgl~j'~~~Mhla~Ejiii'iiy:';p'~~'d~~IlHig~~~nj~~~:~~: 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 $121.00 $ 22.00 $57.00 ,. . '>""'.4"'_:'~-,""; 'l'!'1"";,,rt." "~." +. __... "(4: ,~". . ,<". .,..~ii,'.'. .'it"," ..., "'j"';; ..'~ ~i; - :~.*:. ,n .' ;",: ,,-- <.""'. i. '.. ~ B 'S"" o>,,"~. "'F'#d' ....", "I'''' tall' "t"'~"'A1 t"'''t'' , "'R""I"~-t'"'' ".",," . .~ .,tr;vt~~ ,9r'"et~~!~' !Is,. .}!,I,or;:~;,~r:a)O~~g.fj~ ~e 49c~~ ~~n_::..~"~ 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $~ Bt.o? $ 86.00 $143.00 $186.00 $426.00 $ 57.00 C.'1.?~'iDip'pra!y:/Sen:ices,,~g::feetJ~tsfr"Jr~'!! ,;io $ 57.00 $ 79.00 $114.00 TOTAL