HomeMy WebLinkAboutPermit Electrical 2010-7-15 (2)
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Date 6 -Z-I-l!C/t??
CITY OF SPRINGFIELD, OREGON
225 FIFI1I STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
ELECIJUCAL PERMIT APPLICATION
City Job Number C-()U1 t$/ 0 - tJO 7lj(!)
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LEGAL DESCRIPTION:
17(}7 36tt UJ5"i6(}
JOB DESCRIPTION:
WI V'6 elM~vtfuu'y f 4ul- * /tY r.. q ds ;1el4 ;ev
Permits are non-transferable and expire if work is
Dot started withiD 180 days of issuaDce or if work is
SuspeDded for 180 days.
2. lq>.irf~~1!ON(O~.J1
3. rcoMPlEtE'FEESCHiliiiJI.iF}BEi1JWt.i~.t,":if~,~,~~~i':~;l~;i:clir;:"l?idtI
, . ... " . ,', "W" :0""" . .' ,__n_ ....., -'.' nO " . .... . _ '," " . ,_'",.._,_,', ,"": ,. ,,"':C. -'':', . -"'_: ,'~ __..""
A.'~~w'R~~ldent~l!i~~gleor;~tiIti,F8mi.ly;pl;r,{dl"eU!~g:mir~,
Service IDcluded
1000 sq. ft. or less
Each additioDal 500 sq. ft. or
portioD thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$121.00
$ 22.00
$57.00
Electrical Contractor
OREGON ELECTRIC SERVICE
Address PO BOX ??~7
EUWfE, OR 97402
City. PhoDe ~'-\.:=, - Ib'<s'l
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/V olts
Reconnect ODly
$ 73.00
$ 86.00
$143.00
$186.00
$426.00
$ 57.00
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C. i):remHoraxx' S~.r:vI.ces:O,t;-,J.?~ede!]t;+~;;:':'i;'x;,tii:!Ji(,t;' ',,' (-:4~,,"; '~';"_:~" ,,:'~,:t:;~,
Supervisor License Number I ~ q~.s
IDstallatioD, AlteratioD or RelocatioD
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
ExpiratioD Date I 0 - ( - r '0
$ 57.00
$ 79.00
$114.00
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,
Constr. Contr. Number ~ Lj D~
/ s-Cj-ro
,
Expiration Date ) - { - II
Over 600 Amps or 1000 Volts see "B" above.
D.'c~nli"'Il,.t;~ci1itS ~"
7L=E0LJ
Owners Name ~~
Address ~O ~ ~-D
New AlteratioD or ExteDsioD Per PaDel
One Circuit I
Each Additional Circuit or with
Service or Feeder Permit
f 'f7:dO
$ )lHlO
$ 5.00
. ,",#to" . m~'" ,. ) ,'"} ,;i'",)';'\i,;,_',,_,,~, :<:".-""','",, n' _ ?",.'....]i':,,!!T"~-?
E. ~~IsceIIa~eous,(sefvice/r@ei ilj>tjncI,!d~)"'E'!~~J~s~!L~ti(l(l1
City PhoDe Pump or irrigation $ 57.00
Sign/Outline Lighting $ 57.00
OWNER INS LATlON , _~Limited Energy/Residential $ 29.00
The installation is being made OD property I own WhiC~iD~ Limited Energy/Commercial $ 52.00
::::..:. "'. ,=, ."~ .. ~(\ ~rum':';;~:;tl;;:;=" 'u. "'OO. S''15~1O
~~ ~ 12% State Surcharge
~vl 10% Admmlstratlve Fee 0
5% Technology Fee 1- . q_
tl\I~s~ctioD Reque~: 7:6-~ I. ^,.111 __ r'\ r-:. rv\OTAL . 'D..-">.~G?;:;::\gl.f:lo
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