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Home My WebLink AboutPermit Electrical 7-6-6 ,/ 8,:)1:)r(I\./~..!" I A 10.1i"'::J.Jll {.Lj( D!:t')~!Jl!-qj.~-- - .---. ---- P.U'n"rb'''' -, n n1 I ...,......~} ~~f-..,...!j., . ~. .~1.1~.ir.J...~ 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. 4.\\t\~ ~\t\AL~~iO-, \Y-'t>G~o~~~N CAo.db ~ ?frf') ,,~OB Df:SCRIPTION \.4\ ~l \~\ v+ 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. CONTRACTOR INSTALLATION ONLY ,B. Electrical contractor.ii\\("~ &tt AddressdL\~ f!L \.\1. t\uJ~~\\q Ci ty ~ \\srnYD, O~ Phone !:iJb '6ot toc()'\-1 Supervisor License,Number :\~~i\~ \().\.q<6 Constr Contr. Number ()\\~CY\\ 4. .\S.C\~ Expiration Date Expiration Date S~~Actrician /'" ( \.L j ~'\k^" " "- Owners Name \ \()~ -n)lll.ll)"- ~ Address\ ~() '_ l_. , ~()~~ Ci ty\ ~tli'{\ Phone RJ~ ~~ 1o~1<3 OVNER INSTALLATION The installation is being made on property I own whi~h is not intended for sale, lease or rent. Owners Signature: DATE~lO~C\~----~(ir\~~~----------- RECEIPT #: l J I - - RECEIVED BY: mt M. _ . ELECTRICAL PERMIT APPLICATION -~~t;"'Job' NumbeF (\1C1fi) 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Sum \'lD~ \oD~ Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular 'Dwelling Service or Feeder ~ 4 .s 15.00 $ 85.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to, 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00, $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amp~~T less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits ,. New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 1i~'DpD 5% State Surcharge l \.:)0 3% Administrative Fee' " .C\D TOTAL ~'\ <<-, k~n_ . ...t~.... fj' iDI! tl' !.........., ,,', ,'" ~. . The follo\Nin~\ prcI8(. :;,~, "'~"-u ;~~, ~l\.:: L'.: d "-'.,) zonir:g, o,~d c:i)or; nOl i~""...ih . ..... ...v., appr:>vnL ZO~i\ry;;)...'tflM "' ,[ rJ G \ ~-1 225 FIFTH STREET [;",,,,,~~.\.J.-t- SPRINGFIELD, OREGON 97 A:jjc;;;r.yj s\g:1atiJre '{\ tI\. INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1.4\~f~c\ ~1jS~~Htl\ia.J \~~~~~~ ~~.. -h~B~E\~0j~ ~~~ ' Permits are non-transferable an xpire if work is not started within 18 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY .B. Electrical contractor.ii\.\("~tt AddressdL\'1\ ~ \.\1. ~~~\\~ Ci ty ~ \\S'{urJ\ O~ Phone !i)b' '6'O~ \.o<6-\-1 Supervisor License Number ?\~~~~ Expiration Date H'l . \ . q <6 Constr Contr. Number ()\\~CY\\ Expiration Date .t\. \~ .C\~ Si~ o:':e:s Na:e ~e ~\0 ~. ~~ ~ AddreSS\~()~ A~()~~ Ci ty~\\ ~ ~hone ~~ rA~ 19~1<6 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE~------------\12~~~'\--~-:----- ~~~!!!,,~~v_ ~ '--3\~ E~CTRICAL PERMIT APPLICtT~ City Job'Numbe;' (}f\Ow-UJ 3. COMPLETE FEE SCHEDULE BELO'W A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Sum Items Cost 1000 sq. ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular 'Dwelling Service or Feeder $ 85.00 S 15.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to. 600 amps' 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00, $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less \ 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 1-{j $ 55.00 $ 80.00 see "B" above D. Branch Circuits ,. New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $35.00 $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included:) 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ 40.00 $ 40.00 $ 20.00 $ 36.00 ,:~ .1.&u ~')