HomeMy WebLinkAboutPermit Electrical 2003-8-27
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CITY OF S'~ JNGFlELD, OREGON '
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726.3753 . FAX: (541)726.3689
ELECTRICAL PERMIT APPLICATION The following projecl as submilled has fhe following
, 9"1. 0 I 0- 'J 7-0 30n;ng, and does nol require specific land use
City Job Number 02-00 ....> )" - Date 6 - t7 Morava!.
, '_ U;>t-
3, I cOJ1.fPLE!E FEESC1'IEDULE BELOW -tl-o:?
~o.o u - ot4-J
Oultlwrized_SigQllW..le_
A, I New Residential- Single or Multi-Famil)' per dwelling unit.
Signature of Supervising Electrician
;). -; 1'. J ~ - , J New AIteration or Extension Per Panel
ftttIJU/ VJ - f~ One Circuit ',c
I ' Each Additional CircuitA'!i\\\dth'tov'i'w'< $ 3,00
I . , TS~ Service or,Feeder:p~r\;f~regon \.1\\ \ /
Owners Name L.-;'W'flbVc S \ \\:.~\~U~"'-:'~~:-"I-"\\1\ne ,~,~n"e\~~~
Address 7 21 Sc..o Hs G/crV':"\\OWJi:'I\' J\!il\:ellai"eol\s'(Seni~eJ(.eder Dot'il~tll\ded) -Each IlIstallatioll I
10" \'0" v-' otl\'UV>:l' tU'"'' -
I /"- "'o\\\lCe I ,,(")~ .00\ , Sol \hS
<;;;: ,- \ ) Phone I~ 0,,0 "Pump or irrigation;o{l18 'elsn\'\one $ 50,00
""\"""\.,,,- Ot.hGl'" he \ \-
In 90 y~igiilati\line_Ligj\tiDg,r, \, ""o\iticatiOIl $ 50,00
00' .\.0 ,."'Il'''''' , , ll'I,l'j ,~
ca\litlljmited'*ge[gyLISesiOent!a~2344). $ 25,00
.",d,"Itd'E ,/"!,,,_~3", I $ 45 00
The installation is being made on property I own which nurn,c;IC~l\t",~~rgy "",mmerCIa ,
IS not mtended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
L I LOCATIONOFINS1'ALLA170N
717 ~~
u
LEGAL DESCRlPTION
1763"Z- 7ZLJ
J08 DESCRlPTION
03,0-60
,
per:~ ::-t~::-::Pire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2, I CONTRACTOR INSTALLATION ONLY I
Electrical Contraclor ~ ~~
(j
((fCfl- ~ ~
Address
City ~~
Phone 7Z-9 _/500
Supervisor License Number
115 - S
/0// /aL(
/ I
Constr, Contr, Number do - t.f 5 I c..
/tJ II ja3
Expiration Date
Expiration Date
City
OWNER INST ALLA nON
Owners Signature:
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
$106,00
$ 19,00
$50,00
B. I Sen'ices or Feeders - Installation, Alterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 'Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
/
6J
$ 63,00
$ 75,00
$125,00
$163.00
$375,00
$ 50.00
,,. \NO"":
c. I Temporary Servic~;w. ~M'l'fS\S ~\) \
"t:. "- t>.\.\. \:.~~ 's ,?t.W~" \ r\J~
...\ ,," \lilstall..tion'rAIt"''i'lio~ or.RA~tlOn
,,,\.I o~"\'''' \\~\l\:' \>.~vV'
\\\\S~OO~p~dt(l\iS \>.'0 $ 50.00
\>.\)\2lH t-roll'S'i), lJ ;\\ralj)s $ 69,00
c.C4o\~'Pjrkl to ;\mps $100,00
to.\.'{ "Iv '
~Over 600 Amps or 1000 Volts see "8" above.
D, I Branch Circuits
$ 43,00
0;
4,1 SUBTOTAL OF ABOVE
7'Z.
C;O'1
7Z0
If'f 2-'1
7% State Surcharge
10% Administrative Fee
~ ~~ {ryC'\ MOTAL
'\.)J'.J~..1 ii2 ~ Shared Drivc(T:)lBuilding FormslElectrical Permit Application 1-ll3,doc
~~~
Inspection Request: 726-3769