HomeMy WebLinkAboutPermit Electrical 2007-7-20
CITY OF SPRINGFIELD, OREGON
ZON LOG
INITIALS N ~
DATE '1-~~ -01
SOURCE O'\...^DS (.).2
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225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION _
City Job Number CCy\A Z-o P 7 - 0 0 b Z .s Date ''1 ,.- ;) 0 ,- Or
1. I LOCATION OF INSTALLATION: I 3. i~~MPLETE FEE SCHEDULE BELOW.-- .
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2. I CONTRACTOR INSTA.L0TION ONL!J B. LS_ervic~_~r Feeders - ~tallatio~ Alte~ations or ReJo~a!ion:
/-. r. ~ . '" /) ___ l \
Electrical Contractor (j{/US /4t I~( ,ELEa./ 200 Amps or less .J. (- \&70.00
201 Amps to 400 Amps. ~c_-'f~~.oo
401 Amps to 600 Amps ~ \e.'" '~O(eQ()t\ ~ ~~OO
601 Amps ,~~~~ ~'f ~~\e' ~ ~~~
ov~fOO\1!~' 1'<'09 O\).g'(\ ~. .~A~~ 00
Re ~'lftt1~BR~cet\\! Q'\ Q \'(\, ...\efO it :...\e~
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Installa~~tM&~ ltb tie ocation -----7
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200 Amps or less --,___'C $ 55.00
201 Amps to 400 Amps $ 76.00
401 Amps to 600 Amps. $110.00
Pump or irrigation $ 55.00
..sign/Outline Lighting $ 55.0Q,,\
Limited EnergylResidential $ 28.00
Limited Enelcommercial $ 50.00
Minimu.m~~. rmit Inspection Fee is $50.00 + S. urcharges
~V\'f\~~~~~OFABOVE -==--=_~--J Icb.
~~.- .,; ~~~\.\.. .....~\e" V~~~~tigurcharge . B . Cl8
'\\U \ '?t.~~\\ \j't\fJ't.~ ~~'t\fJ~\ i\dministrative Fee _ /0 bo
\~\CO. O~\1.'t.~ O~ \~ ~ 5% Technology Fee i C- To
~~ ~~ ~~. . 3g
Inspection Request: 726-3769 ()\S\~~ fJ~ V TOTAL _' 3D .
c ~~'-{ "\ ~~ _ Shared Dnve(T)lBuilding FonnslElectrical Pennit \\pplication 7-07.doc
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JOB DESCRIPTION:
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
Address 3333 ? / lJ y'Lt.. tJ /~
~I
Ci~tJ'€~
Phone ~5r:...J~C cJ
Supervisor License Number ~ 2- z...l? 5
ExpirntionDa', ~# ftl/ df/ 2"'0/,
Constr. Contr. Number 6 2- :3 7 7
Expiration Date /2- /2- / / 2 (:J 0 j>".
. I
Signature of Supervising Electrician
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~'37 (
Phone 30Z ~ 95"S3
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Owners Name Mu./l..Jt..\. ~
Address 1> c:> ;30 I'
City C6 r3&A.LCr-
OWNER INSTALLATION
The installation is being made on property I oWli"which
is not intended for sale, lease or rent.
Owners Signature:
A; [~~~~~~~~ent!al_~_~in;'~- or Multi.!!-;"i1Yj>er dwelling ~~it. l
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
$117.00
$ 21.00
~o
Z- ~o /00
Over 600 Amps or 1000 Volts see "B" above.
D. I Branch Circuits
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
- ~
.? $ 100
b
E. I MisceJlaneous (Service/feede~not inCI~ded) -~!lCh ~~~J~tio~j