HomeMy WebLinkAboutPermit Electrical 2004-4-8
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CITY OF S. .dNGFIELD. OREGON .
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~f!~Jill1WJ1W:tassUbmjttedhasthefollowing
(t, tffll1lifnot reqUire specific land
ELECTRICAL PERMIT APPLICATION approval use
City Job Number Cc~"2.!:X:l~.'C I Z:'2.%ate do- l - 06,- Zoning l!..~ .
Date 4-8".0 Cj.
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'2. 5 \0 G.A\o<\.E. E"1'\.t'M ~'\;;)
Constr. Contr. Number i 0'-1 q;) q
/'> n tn
Expiration Date 2l- I '-I. Gn
s'~~"""f)~
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Owners Name Eo'- E~<;'f<.O-.)t2:t1..S
Address 140"'2..$ S~ ~~l /'1"- To~ ~-oE.Mi~~J.I~n~u~~}~&if~~ii~!!~~l~'~~~~iF.~~.~~:i,;t~ti;~i~~"
City ~\.l E.~ ,Ot-\. Phone(,S't>3) EA4. tOd.;4-4.- Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45.00
LEGAL DESCRIPTION
l1 O~ ~ '- 00 O'Z.. '10"L
JOB DESCRIPTION
t--l€(J..) 0 E-b\'\f'tL t;\) u...Ot t\c;
Permits are non-transferable and expire if work is
not started within 180 days ofissuaDce or if work is
Suspended for 180 days.
2.
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..roNTRA,,~~~1:NstAti:ATiONONLYP
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Electrical Contractor ~ L. \ l? ('+r, C
Address 4(0<;1; S :I~ Q 6e..i \ (0 'Soi
City E........11 ~.....c
oJ
Phone (D<;("1-6'1l0
,. Supervisor License Number 3'% 1.;;\ - 'S
Expiration Date
I ()- !-O<..f
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale. lease or rent.
Owners Signature:
Inspection Request: 726-3769
';"(' .",'?~~,__: .~'l"",+;,,,. <.'~.'~'~; .V", 1;"\~:~;~'~;;~".,'-':;l;y\ -.;c ',-:'_i)i....~?; ~tof~~i1i.><""''':''.J'i;,;l;, ~"":~f".:'t.;;'l,'t,t 'l'_'L~."tt~~~~
A. 'New.l{esident~I':" Single or Mtilti'-FaDlily'jier'i1wellinguliit:' ,.'
. ., - .-. '., ". ,-.' .,'-
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufac!' d Home or
Modular Dwelling Service or
Feeder .
$106.00
$ 19.00
$50.00
_.... ',,,:,~~":,; ':': ,:"~'C~ .' -,-:,.t,~:.'., _ d s': ':. "";.:::.,,,' ~~. 0-~'.-~". ~{':< .,>~:;..,~, :iff. l.~,,~':'Y\S;"'~; ',.~~~__,,-~" l _/:
B.::semces'or'FeflIen <':.In.stallatioD't<\lteriitioii.'.6lRelo~iitioii:A\
~ '.' ~".! ','. " '::''- >.-' .',' :~,', 1': . ,1' ,:p, '. '. " ;, '''!., '.~. "., - ':," --c; .','. ,;:-<."'" -....~.. S;,' . ,-,~~,." "',
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
'Z... $ 63.00 ~ "2.'=>.00
$ 75.00
$125.00 l1..S.oo
$163.00
$375.00
$ 50.00
G. ::;T~~~~~,6~1~~,W~~~~~::.if!~~~~~:::,~i~i~~~~i:iK,:~.~iui{;;~f(f~t~~t'0~r~.~!i~
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.
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D. "~ BrancbClrcultJ%':\~V~;;,~:';;t~"~~-f;'-7h~..'-~~";_',.'1.JV'~<{, Jt,"'\~,'\}i~"~~";lY~'J~:,J:?:'i/t"j.
',:~". '_,', " ,; (';,--", ,u,u ,,'-!!'_'.(A;;. ,t,j,~-':-{,ti,~{fA\", 1 ',':;:,,~~','~.'~~;;~ 1).,,- '.~~"Ift ',-~'.:',"p",..:t.,:;:':, tr';'~~'i~:,:"'~(l~
$ 50.00
$ 69.09
$100.00
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
~"L
$ 3.00
t86.cc>
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4. ~~UBnjiif:6jf,~(WiI:.~~Y;i.i~:'<;??'i:~;:~~it;;ii;.\. de-:, 1.00
'30. S,,>
1:!,,-:,.'10
5l t .1...~
7% State Surcharge
10% Administrative Fee
TOTAL
.
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~;\:;~~'.' ,. :";> CI I YOE'~~RINGFIELD; OREGON :'~\<""-._,.,:'J,<i\i'),,/::
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225 J<1J< 11:1 STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION 4-"( 04-
City Job Number ((1M;L" 0 3 -0/).).'1 Date ,;;zp-(f)J/..
1. .f:ifcAfjON QFjiffST'Aii:Aifro.N?,:':{'/i'~ 3. ':COMPUITEFi1iSqJEDifi1iJifji.(jW0':::'~i's:'r~j:<f;'
:-25"/0 ~~I!v- ~~'2-7.b? . '.'-' , '., .~" _, 'J, ". '. '.'.. . .,..
LEGAL DESCRIPTION ('1 0;' '2 'L 0 ''-7\.. New Resi~ential- Single or Multi-Family per d.welling unit. . .
O N./..u.) 1J.ei1:r;d.- t?t,J'ilc/';/I'7 Service Included .
JOB DESCRIPTION / 1000 sq. ft. or less $106.00
Each additional 500 sq. ft. or
portion thereof $ 19.00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or jfwork is
Suspended for 180 days.
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CP~CTOR4NSTALL:ATIO!(ONL<Y' ..
2. .... " . ."
Electrical Contractor :::rt\ E. Ii? 0+r, ('
Address 4lD~5 I~C\bej \.0 'S.i
City E..... 3 <2..\<'\ 9
Phone (091-51,0
. Supervisor License Number 3"6, J - 'S .
Expiration Date I a - 1-0'-4
Constr. Contr. Number i (]'-j q J q
Expiration Date 3- /'-j. (V-I
Sign
~
.........
Owners Name FlfjeVlP, S k(}(ff/-cs
Address 14{J;26 50 Ftu-ml1Jfoh ;ef
City Ifr:ruJerl-fJJ1 Phone (50~)M"I-4I/I/,/
OWNER IJI/STALLA TION
The installation is being made on property I own which
is not intended for sale, lease or rent
Owners Signature:
Inspection Request: 726-3769
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
.. ,...., "'_'" ~~,f/. .'_," ',' .~_.~. .;~: .,\.--.....-_,.':'-_ -~:._";.::5.i._~., :"',/,<.,-<_'_<",',"""'-
B.ServlceS cirF~~fs''- Jijsi8ii~tiOD;AIi~niti~ns oj:Rel;;~~iiori::::'
,,- " -. ....,. ,"', ".' '-. , . .' , . . .' "'0 .-"-'", --',....'...,;.. .;'-....,:-;,....N.....;-:.~.',: .
200 Amps or less 2- $ 63.00 \,-,,",CO
201 Amps to 400 Amps $ 75.00
401 Amps to 600 Amps J $125.00 \'Z.5'.OO
601 Amps to 1000 Amps $163.00
Over 1000 AmpsIVolts $375.00
Reconnect Only $ 50.00
C. '\..T..'..e' ..m'.' .p".o".'...ra'..'.ry.....'...S. ..,".'.rv'.....'.....c....'e.'..s...'.'..o.r."........F'...~.'..'...A..'e.'.r...s:t...;.......',. ' ......, " .." ..,
- - - - - - - ,,~ _ - _ _ _ ~cu - _ -.;.':~~>~!;:' ~.;.p:;:.j,::,~'\;~~;:!.(i:::"~;',':~Q:::i;~;~~~~;~;;:.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
$ 50.00
$ 69.00
$100.00
Over 600 Amps or 1000 Volts see "B" above.
D. ",: ~~~.~~~.:q.i'rc:tii,'~-;. ~ ~;~:~:.,'~: ~'~:.,~~"~; ii;~i:~!}~_:}f~!;~\~~' :;;~. .i:ft~' ;~~ ~:i~~~ ~S:~,.~>~~\~:~f~~~::
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43.00
~J-
$ 3.00
l8b.OO
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E. . Miscellaneou.(Servicflfee.Jej'.DotiijCJ~,i1e~);~~adiIr,i.tan~ti~~
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00'
Limited Energy/Residential $ 25.00
Limited Energy/Conunercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
"'. '
4.SUBWTAL OF~vE;' ..
".,. ..
4:?il.00
110.5"'>
4~.'"7o
5l\..Z.~
7% State Surcharge
10% Administrative Fee
TOTAL