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HomeMy WebLinkAboutPermit Electrical 2006-12-12 , 0: J CITY OF SPRINGFIELD, OREGON' . 8";"..0 ZON mu.<:,; ~~ INITIALS NfVl . ~: DATE lJ_il~ IOCtl. . 1liIF" SOURCE fY'a-{X~-' ,.) =\ Date rZ-IZ-Ob 225 FWfII STREET. SPRINGFIELD, OR 97477 . PII:(54t)726-3753 . FAX: (54t)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO".tA'ZOoU - 0 Il(f'! I. LOCATION OF INSTALLATION: 3. COMPLETE FEE SCHEDULE BELOW .:?3'J3 ~"ve:-4L~b't ~ ':::h.e... 2. Electrical Contractor C/.l<:..h <- J 41 /(y 6.fcc:l~,<' 200 Amps or less $ 63.00 . ~ "I/.-; _ ' 201 Amp~~o4P.,,2 J\.~s $ 75.00 Address q:s I ~ 5 t-J rv /"" /:'\1 S 401 Amils fO~&lbmj1v1i $125.00 ( 601 M~ft6'~()1~4j.o. $163.00 City B C'AuQAo...J IY Phon ..,o:~) "':Jf - 4' 6 0 Over ~&(16 ~6\!ll ~ob<-/(;.9. $375.00 I =-y-- , R~~61?rYh '00 &,,4;>, :ro,&, u;. $ 50.00 o?6~~~';~ 7-a :':-;;.'0'6 '<f&z" Supervisor License Number ').11/ C. t... En. c. Tem""f1;~ s'l!lvl~1d1i{dSr.~& 1"&9~. -&"..: ~& ~/&I" ~ :l}1l,~I"~ O~ ~& {r/ Installation!/A.lt.Q4tioRl1>r~o'llilit.;"ls-... ~o.,^i9'y'o.~, Expiration Date I () - 0 - 0 IS ~ l' ~&;l "0,,-"$ 'Q v~ .,,,~ v~_ 4'0 200 Amps or less 19a 0"",&"" IS' O~ ~~ &,(\$'5112lUJ Constr. Contr. Number I '-{ 'i' ;2 .::t. ::L ~, ~C! 201 Amps to 400 A,,?p3'<1~~~~ I' 0~' ,gS"l'f~~t'fo c. 'Y<:/');'0;.o<s '?;. 401 Amps to 600 Amps ~~ ~'i'61'l~ "'4-~~~0 Expiration Date 7 - 0 (. - 6 '1 0, 0r/) ~L ~ "-1/::' . '12.....6'6 7 -,~ '/~ 'J% ''7/):' Over 600 Amps or 1000VoIts.~e B~~~",~ Signature of Supervising Electrician rl'6'O'f'~C':f'o (/, DJX Branch Ci~cuit~ _ _ _ ~ j) /J VI_ /J 01' <? 0. :PO~(W ,Nteration or Extension Per Panel -tCrrr 1(1/ /,~ rA?> <r <'Ohe.tfrsuit h h l. '00. ~~&dffi!ilJI.!al Circuit or with ~ ~ ",--(' V 'Sejl'ice~,F~95rPermit $ 3.00 Owners Name c;;-o- . ~ -rr ,.. . Va ~4", ~ ' _. _ Address 70 ,'Z --,.r I" 7 '7 E. Mis~an~~~M~iCelfeeder not included) -Each Installation 'v~<.)~ '1'1" - - . City f:--u. (-611' E Phone Pump or irrig~on <?)' $ 50.00 SignlOutline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial "3 Z. $ 45.00 lit" 0 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.: SUBTOTALOFABOVE - ,- !l{I/O -- ++-..... 8% State Surcharge IJ S ~ 10% Administrative Fee I L/L/ 5% Technology Fee A "L^-) I _ 7 L T ZS% fINlUvllw ~.;><7" TOTAL $ZI"3I~ Shared Drivc{T:)/Building FonnslElectrical Pennit Application 8-06.doc LEGAL DESCRIPTION: /70'5 2ZC> C> 60 ?O2- JOB DESCRIPTION: Lv (j:z) \JO\c...t. ('bA-rA Permits are non-transferable and expire if work is not started within 180 da~'s of issuance or if work is Suspended for 180 days. CONrRACTOR INSTALlATION ONLY OWNER INST ALLA TION The installation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. New Residential- Single or Multi-Family per dwelling unit. 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. Services or Feeders -Installation, Alterations or Relocation: $ 43.00