HomeMy WebLinkAboutPermit Electrical 2005-3-4
225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX; (541)726-368~~\\\:
ELECTRICAL PERMIT APPLICATION .- c\'C,s "':o-0\~e
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City Job Number / '> _ (J()I'-f~ Date . ~.y\ s (,\0
, 0""'\ 0013
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LEGA~ESRRIPTION J ~d~V' Ma~uJ'i... ,2W A.
~(J \ 1-\ S5111n~ fA-~ Sub i..of 110 Service Included
JOB DESCRIPTION . ~ # \ (lID' /) 1000 sq. ft. or less
J\\.1/ ~tYI nEach additionalSOO sq. ft. or
~J "'"5~ fa ~r fe ,d (~.f U + \V' \ portion thereof
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work ;'S Modular Dwelling Service or
Suspended for 180 days. Feeder
1.
2.
Electrical Contractor -;7-Io.RtJ J7{J jJ\. j 8k.l KJ:::..
Address I? () ~&ir' SVLI <)
City ae.c:r--
u
Phone f)~ -W~(
.2,., /7 (7
Supervisor License Number -.JC/ ~
Expiration Date ICl/ /- 0 (0
Constr. Contr. Number I / It? ,~~ /
Expiration Date
/(I}-/_ D b
Signature of Supervising Electrician
~JL-2_S/~ -:l
Owners ~e
Address vf\ ~ . _ ..
Ci~ ~~ Phooe -W}(Y \CS \
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
(
~
$106.00 100 t00
$ 19.00 :>l:5tOC)
$SO.OO
B.
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 7S.00
$12S.00
$163.00
$37S.00
$ SO.OO
c.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps .
Over 600
D.
$ SO.OO
$ 69.00
$100.00
~(oo
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
$ 3.00
E.
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ SO.OO
$ SO.OO
$ 2S.00
$ 4S.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.
I q~,oo
I ~,S-6
,q,,-/O
I J-~,1G
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)/Building Fonns/Electrical Pennit Application l-03.doc