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HomeMy WebLinkAboutPermit Electrical 2006-3-14 ~ 1-:-'-" -'--- -h,', ;-~r'" ;.) _r~n I '~i(;1~~[~tSl ;:() :Z:~(::(')i~ ' ~. - . " :~':;~~~~~:'~~:~;~~i~ 1~~~o~~:ln 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54])726-3753 . FAX: (54];';;;~3~8; zC1lng~~~.a?_VY1q _ I~U5CT1UCAftl'ERMITAPPLICATlON " '0 ---r:r, <. J CityJobNumbeTl './Jf?7 2fJO(,CJ -()030( Dale (5-'~"/#r.:rr~b I. I LOCATJOlI' OF J.lvSIA I.LA 110!\' (7 d() >9tf f()~J ' LEGAL DESCRIPTION /7 Os :;)s 3q o07(JQ . r JOB DESCRIPTION 1000 sq. ft. or less /.' /" . <- . ~ Each additional 500 sq, ft, or UlLl/Ylt:j _ ,.J, t t)f ,., rr.!} ,.(d-~ ~<fl6J$ion thereof(17P8G-G88-008-~ S! Jalua8 $19,00 UO'lrn'l"n., Allllln u05aJO aljl JOI Jaqwnu Permitfare non-transferable and expire if work is Each Manufact'd Home or 5 not started within ]80 days of issuance or if work is Modul"r'D~~iri;illS1!,!Jic~\W\J) 'JalUaO aljl u!lleO Suspended for ]80 days. Feeler salnJ aLII 10 sa'doo u!e'M ~'"'' nf)x5~'8ao , , .- Vl0-C;Sfl 8\;10 lj6noJljl 0 ~oo- ~00-GS6 \:1\;10 U! 2. !: CONTRACFOR. INSTALlATI01\'ONIX B. ! S!lP1~()s:<ir(~'Cr([rJj$:d l;u<t"-lI!.eliy~l~'U!Srati!\~I3t'Jor2fion: . iilll'ln uoBaJO aljl iiq paldope ::lain! MOIIOI Electrical Contractor f:-u.<l U\, F:\~ (+.--i ( Q,'N\I I u...200 ~P,~9r\I~~J!nbaJ Mel uoB"'~ '~~~~1ifll!iv L-- , () 201 Amps to 400 Amps $ 75,00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163,00 Over 1000 AmpsNol1S $375.00 Reconnect Only $ 50,00 Address ,\::l C'I >(v")...,~ V"().<L c::.\,. City .\'=.\,~ c"'., Phone ...3.':14 - 7, S".1cl Supervisor License Number ~ I ~ ~ ~ Expiration Date \ 0 \ ' \ n- "7 Constr. Contr. Number qD ;;) 0 0 Expiration Date .~h-, \ n -, Signature of Supervising Electrician ~ .1JL:h. Owners Name l.Ai<t.L1e.r-E'. ~.r<..-r1 Address loRlf" 0 r S"./-.. City 5'rhA Phone 7 2(, ~ h C/2-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 3. i COMPLETI, PEE8CmmULE HELOW , : ~ , . . . A. I: J'\c~r R{'~:idc[lti::I- Single or ;"lulli-rm~li!~' pto.!: d~\'~llitlg unit. Service Included $106.00 C. l''Te~ptJr2TY Se~\'il:t'S ur 'Feeders InstaUation, Alteration or Relocation ""VICE' ~ 200 Amps 9r1less. - -, E Wm:II( 201 Amps t~14!l9l\mp.,\I1IT SHALL t"f ~R ~.b~ IS-NI}T 401 Amps tMo.Q.~ED UNDt:,K I MI" 1~~~dFo;1 , Over 600 AiDpsW.i'OoO:fJasQ~ \~,/l.a~~J~U ' D. ' Brantll C/l.Nllil180 DAY PERI D. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43,00 $ 3.00 q lo-cJ "3 i' . .. '. . E. ~'1Vi.iscdlan('ow,: (SC'I"\'k(>/fN'dcr not included) ":"Ea.l',b In~tulla,tiun I ,_., ' , ' Pump or inigation $ 50,00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ,,' .' ..- ,',. ". . 4'I:sum~!tA~~ciFAn()IfJ,i, 8% State Surcharge 10% Administrative Fee 7:';;(~(J7) '6-7(P 1- -;:)c, :Ili--Lj < ~ TOTAL Shared Drivc(T:)/Building FomlSlEleclocnl Pcnnit Application J-06.doc