HomeMy WebLinkAboutPermit Electrical 2006-8-6
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SPRINGFIELD --=:--J ZON (Y\11 G
W.~"-l INITIALS N0
'_",- .A!. '" DATE '!..... 'i .....U(.,p
I'iIIJI SOURCE f'^ "
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COMPLETE FEE SCHEDULE BELOW
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
, 1. LOCATION OF INSTALLATION:
r 333 '~I~t.t.. ITc-Nd U
LEGAL DESCRJPTION: /70-:5 zzoo 0000..\' New Residential- Single or Multi-Family per dwelling unit.
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~H/1It. - tv -j",Jr/lf,bn5 PoW,;., . {I<<<.i i.- d,.,J] Servicdncluded
JOB DESCRIPTION: 1000 sq. ft. or less
Low Vc;(+ filA:!""~/ ~ Each additional 500 sq. ft. or
/(/t6.i At&- ,............ portion thereof
Permits are non-transferable and expir: if work is cJ cck Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. Feeder
ELECTIDCAL PERMIT APPLICATION
CityJobNumber (OlAAzooLl- 0(4 ~o
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor (~~t Ll"" ;c,(.
Address ...17'</0 D.-J <5W . \wLld>
City )('I'(J~' /1 Phone :f<f(-(l..{~-5>~J
Supervisor License Number ]M/~LfA
Expiration Date 7/ () 7
Constr. Contr. Number IIl/1S-
Expiration Date /I/OR
Signature of Supervising Electrician
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Owners Name ? 6k.~ t.... o:t4-l-f (
Address 'pc::> 1?Ot< flf 7 ..,
City e-u. GreNe Phone
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Dale
.
$106.00
$ 19.00
$50.00
B. Services or Feeders - Installation, AJterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolls
ReconneCI Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less $ 50.00
20 I Amps to 400 Amps $ 69.00
40 I Amps to 600 Amps $100.00
Over 6o'OTAr'iiP~Tof)!O!JQJM?I!5deaWB," abQve.
In""", .. , . ", reQl1fres YOU to
D. Br.~lic)H:ircuits adopted by the 0 . .
Nolitication C"nler Th _ regen Utility
Ne"j:;,\lteration.otoEx en'sion'Pef.'Plilfel are set forth
-. " '''oJ''- U]-UOlO th
One Gircuitv . rough OAR 9$ '43;"" _
. -. ,ou may obtAin ~ - -""
Each Addition, al]CircUlt or withopleS of the n lies hy
'"_."..,, 'I '8 "An'" (N $ 300 '
Service or Feeder Perinit,r. ote' Ihn '~I~, o'
'''''..10", lor the Ore 0 ".-'~,:,II ne
C ... 9 n Utility Notification '
E. MiscellaneOll'sn(S':~~err.MI€iJlio!:.jp,cI}';ded) -Each Installation,
Pump or irrigation $ 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidentiaI $ 25.00
Limited Energy/Commercial 3 $ 45.00 1.5S"
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
. .
Owners sign'l.'tGlICE: , 4. . SUBTOTAL OF ABOVE
THIS PERMIT SHALL EXPIRE IF THE WORK 8% State Surcharge
AUTHORIZED UNDER THIS PERMIT IS NOT '10% Administrative Fee
COMMENCED OR IS ABANDONED FOR 5% Technology Fee
. ANY 18Q nAY PERIOD.
InspectJon Request: 726-3769 (jif-r TOTAL
q \ C"'\ Shared Drivc(T:)/Building Forms/Electrical Permit Application 8..o6.doc
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