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HomeMy WebLinkAboutPermit Electrical 2006-4-24 _._------~. _.~.. ---~ --,.----,,--. - --.-,--_._-- , ..--. -.. "-'. ~-..,_. -. . :;:-:::~;7: :~~::.::::~ ::~:..:::' 225 FIFTH STREET · SPRINGFIELD, OR 97477 0 PH:(541)726-3753 . FAX: (541)726-3689 _~~EL'J!.l<L~'.~::7f. PJKfVynfT ..AlPPLJCA'lfIfJ;J"tT City Job Number~ -- trJl ~ ::< Date $ o~/ci;<//~uvrp / _ 1.jjjJf!!:!~'B~. ~Rt'~f~$1ti!;f~~1fJ~~\:~:: l(71~/i(l1\p"'f ~~ u:/~, LEGAL DESCRIPTION lfO~34-3L{ {X3JOD , j JOB DESCRIPTION, 3. .'.>:!?ijl~/lf:f;;fii~~-~~~~J;f~\i.tGl:j!Jti~}~~:f!1f~::o.i-1(.-.-.'.:...>.. _:. .... .: .. A.~eVfkt~ii#~~~H:~!.1~t~~~;~r1,~~~"~!f:l~1jtfl1t?~",)h,,:~liing:J;~tit. (:....'.. ~ :Service Included 1000 sq. ft. orless / Each additional 500 sq. ft. or O\Yto portion thereof \' requireS Y _ ,\4?" oQOII a\N Oil Vl''''J Permits are non-transferable and eYnjre if work is Each\Maitufiibt'd HometoI8 Oreg se'l. ~orth -r ""1'~""'- -'(0(.' u~ re \ not started within 180 days of issuance or if work is IX' Modu1ar;~enmg$er:vi~oi\eS a 9h 2. 00\ - $50 00 S ded ,\,-.;,.\1 pJ\v' \ 110;,'-' Op.p. 0- uspen for 180 days. 10' ~reetJer cellter, h OLlgh \ s uy . . oti1\Catlon .00\ 0 t\ Ir , 01 the !L1 e _ --"'n.~>'Cmo"",r.''''~-''''-n.-'C-''''C''''''''''~n'';fh_71l_~ Nil. """",-;;o~()l.}\ _, -~,fi(\Q\es_, .-,;.-t=-rYA-~ ~_.... 2. :...,UH: !,j'("''f:'''''-''-:'L-::...-:J.,!D':ir''~L.;-'~.1 !iU-,:,: 'LtJ:'-:~~ -. . vk'r?e'~!:5 a:rtt~rY'-',~~itiif~('Ra~~ti{lm G-!l r-;:;:?'G~3r~ma: - [) -Ii Inu.r III gO '(oLl ma'1 r \NG\.8. t~'\ Noti.i\CatIO\1 Electrical Contractor l1.f'fA/ ~1\l1 ~h.f...., 1:f::!c.I:ll't- eLC'(? 2g~\~s%F~~;egoll Ut\\lty 31 ^) $ 63.00 k } I ;r J II I /l, ~Oh~{ot~o ~JO-332.-2. . $ 75.00 Address 1(~1~ Ij;ffw. I1tl,e<;s~.l Y/~II.UH~t8WO~~ $125.00 C ~)" 71(/-~Cf5 601 Amps to 1000 Amps $163.00 City Ci A fJt.Y\ 'C.. . Phone ~~-67'1? 74';"~1 Over 1000 AmpsNolts $375.00 J Reconnect Only $ 50.00 $106.00 / Or; $ 19.00 / I Y Supervisor License Number I/L t/ // S Expiration Date / (J-O /-07 Constr. Conn.. Number -4.t-ZcJ'if c.. ..~:~~~~~~Pf~~~..~~~S~.0~~~6i;'~~~~_;'f~~~t'.f#~" ~ ." Expiration Date i - ('-b 7 Si-lJ;J7lhciM 'v' . 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 "R" above. D. $ 50.00 $ 69.00 $100.00 The installation is being made on property I own which is not intended for sale. lease or rent. New Alt.:.. ...~n or Extension Per Panel One CircUit ' . Each Additional Circuit or with · ('. /l ____ Service:or F~~lPertnit,. $ 3.00 Owners Name ...:;f4.,p12f'L. ') ,nn.s" !J;>~,',u;-:::Ep Ulv',:'JE1PJRE _ _. .. .. . . Address ? -0, ~W (Or n( f E.~'fii~ilf~1r:x%J'~~;~l;f~'iii}'fi~f~"i{.,,~.&.i~ CidJ, O~{Q i~_"Phone5q{-57<1 -d~ PumporirrigatioD (,100,.' ONEn l$oW.o{;JT 1Y7.7 9 - ~ Sign/Outline Lighting . $ 50.00 OWNER INSTA:t:iXfION 7 l{() I Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electrie Permit InspeetioU: Fee is $45.00 + Surcharges $ 43.00 O\\-'llers Signature: 4. ;)';)() ~ /7. ~d j?-.o-o ~ S9, ~O 8% State Surcharge 10% Administrative Fee Inspection Request: 12~3769 . ~j )'JsriU~~CJf') ~ ~ifo'i\')J..lf;)l.f TOTAL Shared Drive(T:)IBuilding Fonns/Electrical Permit Application 1-06.doc