HomeMy WebLinkAboutPermit Electrical 2006-7-26
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. k ) . .0 A gl Q001QOOfflwrn,tY~ AR 952-001
PermIts are non-transferable and '''''I'I'..~Qo. may ObtcliAcb~~miRr .
not started within 180 days ofissuanee or~ flh~ c~merM~Rw~~~"S:hIV1~loP. $50.00
~spended Cor 188 days. numoor;:~~~~ill'lr, p on;~~llt~ij~6'~~ili.~\#~;;';;)
Elecbical Contractor ~a/ ~k'.~ fJ2;'c, tL~ 2:'~~~':; less"'<~ ~3.00
Ad.L~ 1(3Cj<j ~;/fwl ~~ if ~~~: =::~= :1~~0
C ?;4% 71(1-~qj 601 Amps to 1000 Amps $163.00
City .J:1,uJ~"C.. Phone 1/~-67l{1 7q;...~1 Over 1000 AmpsNolts $375.00
J Reconnect Only $ 50.00
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225 FI.. I h STREET · SPRINGFIELD, OR 97477 . PH:(S41)726-3753 . FAX: (541)726-3689
~~~~~~~;~LP~~ ~~~TION Date
Supervisor License Number ~O~
Expiration Date I ()-o /-07
c.
InstaUation, Alteration or Relocation \
200 Amps or less
201 Amps to 400 Amps
40 1 Amps to 600 Amps
Over 600 or 1 000 Volts see "B" above.
Si""9f~~~ NOT D. NewAlL"," ,..or_.P.........
IMd) / LJ/ -) ICE. I One CI1'C\l1t $ 43.00
O:~N~1~r. ~~~~7i~~.r_~",,,>C.;";;:,:::j';;<h;',
Address~ ,:) \(_ I . 't . A BA';;d1f:r ./f"'~nl!I~1ft~iq~,"IIJ:~~!>:!;~'~.~~~(
City ef\.O~ Phone, ._ . Pumpofi~R $ 50.00
Sigo/Outline Lighting $ 50.00
OWNER INSTALLATION Limited EnergylResidentiaI $ 25.00
Limited Energy/C,..,..,...~;.J $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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Bit \ . 0'0.
Constr. Contr. Number /<. tz9'6
Expiration Date ~ -'-07
The installation is being made on 1'" ul"erty I own which
is not intended for sale, lease or rent
Owners Signature:
4.
Inspection Request: 716-3769
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8% State Surcharge
10% Administrative Fee
TOTAL
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$106.00 \ '\:Ao.r!!, ')
$19.00 \~
$ 50.00
$ 69.00
$100.00
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Shared Drive(T:)lBuilding FonnsIElectrical Permit Application 1-06.doc