HomeMy WebLinkAboutPermit Electrical 2003-12-17
c~ a~ SUbnJ;~led has the tollowing
, ,,_ nol requine specific land use
225 Fb 111 STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX:p(iS~rl:>}7M!6-3689
ELECTRICAL PERMIT APPLICATION Vl7 Zoning
City Job Number C.clW\. '2-O0~ 0(;. Irl-O Date t"}....~ -O?J Gate
1.
60'10 InILA
LEGAL DESCRIPTION
J~()LO:? 3~ [)D/~/
. If'"
JOB DESCRIPTION
CC/VY'-r ~ ~
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor e A 5rS /l)e' (LeC 1 KJ(
Address 3 'g).5' 3 B05(~ G ~ GAf'Jf
City SP r;=l..{) Phone 7 Y / -/ Y1 C;
Supervisor License Number L17)' 75'
Expiration Date ) () -6/- 0 9
Constr. Contr. Number ) j 7 7 7 D
Expiration Date I 0.- Q 1- 0 <t
Signature of Supervising Electrician
1&J~
..
r
D . 1~?14
j
OwnersName tlA'1OCJ..i ~N7E{(fR.15fS
Address 36.1.). Stw.6-LAClE/?. Pc-, '#=))0
City R~1n6 NO Phone 7 56 . / 17 ~
-,
,.--'
OWNER INSTALLATION
The ltGiflM1i\is being made onl'ro!2..eW' tAr\. KYb...~.C...~.\
IS nOT\!lf!,n~M\Sfl1S,H~ldi:)keHBt \ . L.- I' " ,.
nR\ZED UNDER 1HIS PtR,r~\ r \~ hu I
ownt~~~e:ED OR IS ABANDONcU FUP,
ANY 180 DAY PERIOD.
Inspection Request: 726-3769
L.nf-
11. - 1<6 .D 3
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
B.
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 Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D.
$ 50.00
$ 69.00
$100.00
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
4.
\-\s -
~ I~
~ .c;f)
52.UJc)
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding Fonns/Electrical Pennit Application 1-03.doc