HomeMy WebLinkAboutPermit Electrical 2003-8-8
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as submitted has the following
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~~lfl ~8li9'ot require specific land use
approvlil ~ ....r.... "- n .
ELECTRlCALPERMTT APPLICATION Zoning rt'lI-
City Job Number 0 Z. - oOq )5-01 Date ~/ L/ I b3 <tA/{)~ \
-, ~ - d~
I. LOCA110N OF INSTALLATION 3, COMPLETE F~~etl1!B~'JjllLU"" '
,) 7 Z 7 :s co IU C:r--Lar/' Z:l fL
LEGAL DESCRIPTION A, New Residential- Single or Multi-Family per dwelling unit.
170 3 'Z. "7 Z '-( 05000 Service Included
JOB DESCRIPTlO~' /Jvc.../C>-(Lfu:s c-; ~J ~ 1000sq, ft. or less
.-' I'- 1,--t-> ec...., -r:J Each additIOnal 500 sq, ft. or
7 ~, .3eo-\\'3. c.. ~^ "!>i. Sc portion thereof
$106,00
$ 19,00
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling S'(lI<~ 9t)u.\~ \I $5000
Snspended for 180 days, Fecr'egon \a~ leb egon U\\I\\. '
EN110N: I d 0'/ tM r -e set tori
2. CONTRACTOR INSTALLATION ONm-r: ~ fUlfi,l); e.~W~hUsli}'!"'\frb~~~W!.ac..iQn, Alterations or Relocation:
10\. 0 \\On C0n\~~1 0 thrOUgh e ruleS \ I b 3
Electrical Contractor NO\l\\C~ g52->gQO.Amps,ar L'ti'Pies ot \h hope $ 63,00
in O~f'I'I'O\l r?VJA~~t\~I~~'~P~ \el~~ica\iOn $ 75,00
Address OOS~\\I1\9 tliV P'Ant&{~"g1ffiQ '6lil!~~~~. $125,00
Cu~oart(j(j~'A~g"lt$~niPS $163,00
City Phone f\ QllVll,Sfooo AmpsNolts $375,00
Reconnect Only $ 50,00
Supervisor License Number
1f
J~
o
Expiration Date
Constr. Contr. Number
Expiration Date
Signature of Supervising Electrician
I
Owners Name~ ~ sh' ~Q~ T6.r"'rn..~
Address l2...1 ~-\:\5 G.\ll~, b~
City ~r\, Phone 'j'3(,...-8'2.2J)
OWNER INSTALLATION
TIle installation is being made on property I awn which
is not intended for sale, lease or rent.
Inspection Request: 726-3769
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
$ 50,00
$ 69,00
$100,00
Over 600 Amps or 1000 Volts see "B" above,
D, Branch Circuits
Ncw Alteration or Extension Per Panel
One Circuit \-\t. \t\IO~\\$ 43,00
E~~dditional Ctc'rt~~^f :'\~ tt\ ~O~ '"
~Q1~~e~tes~\i;~\S ,,~~,,\ ')9_ $ 3,00 I
~\S ,,~~ U~O~~ ~\)Q~~\) \,UI"\
~"'~~~~~~~teeder not included) -Each Installation
nW\W\~~C ptJ\\Q\).
C!..'/ij'1\ 8Oi1ttl.~tlOn $ 50,00
~ivOutline Lighting. $ 50,00
Limited EnergylResidential $ 25.00
Limited Energy/Commercial $ 45,00
Minimum Electric Permit Inspection Fee is $45,00 + Surchargcs
4, SUBTOTAL OF ABOVE
72..
50(,../
720
$ '8L/ ~
7% State Surcharge
10% Administrative Fee
TOTAL
Sh.lrcd Dnve(T:}/Building Fonus/Eleclrical Pcmlit Applicution I.03.doc