HomeMy WebLinkAboutPermit Electrical 2003-9-30
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'f~(ll' ." . 'CITY: OF:~~.,,-tlNGFIELD, OREGON' {, j : ;~."., ;
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL,fERMIT APPLICATION
City Job Number \.. ~ilrO~ ~<6.<6 Date
I. L L9,CA2"IOJy OF INST;1LLAT(ON , i
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LEGAL DESCRIPTION ' -(j
V'l()-nry243 \.\'000
2.~
Permits ar on-tra s rable and ~P~:-::n~
not started within 18 days of issuance or if work is
Suspended for 180 days, .
,
JOB DESCRIPTION
2. I CONTRACTORlNSTALLATION D,NI.Y I
Electrical Contractor )\.eo-. \1\ I (- 1./ i' ;:\ 'tl. \ (
Address f. e>, ~O'f-- ~ ~ g r
City
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a. '1 yliJ...
Phone q:, s- - SSO~
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Supervisor License Number ~ <6\ 1 S . ~<;:)~<;:)~
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Expiration Date I () . D i - '1 oJjJ{~ <.c<;:)~
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Constr. Contr, Number "\ q.., ~,:~'?).,~<::l
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Expiration Date ~t... ,&~-if~~L1
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Signature Of~pti$~~awci~'<-~
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Owners Name \:tikw. ~ ~
Address ~ \41L.~
City f)JO( ~ Phone l~ . ?JaW
OWNER INST ALLA nON
The installation is being made on property I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
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3. I COMPLETEr'EE SCHEDULEBELOHT
A. r Ne); Re~ia;.;ti;l~ '::si~gi;~;'M~Iti:F~;;il';~;;;;d;~;;Ii;;;'~;;ll:'.~l
Service Included
\rxo,~
51.c;i)
1000 sq, ft. or less
Each additional 500 sq. ft. or
portion thereof
I
3
$ 19.00
$106.00
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$50.00
B. 1::S~rvice~.9rFeeders - I.nstalla'~ion,;Alter_at.i~n.s Qr;~eloc~ti~n:., .!
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts ,
Reconnect Only
$ 63,00
$ 75,00
$125.00
$163.00
$375,00
$ 50.00
c. i Temporary SeAiees or Feeders
- . .
I
Installation, Alteration or Relocation _"Q._\
a" .~" ^ ...f'\ "'"
200 Amps or less ~ ~1.. ~ $:50.00 ,;;:x).lJJ
,v i:' 0~'-~
201 Amps to 400 Amps .~~.o Co; $,69.00
~ 0-J '" ?::;:V ,..,C?
40 I Amps to 600 Amps ,0 C~ '*. ~$l OO~OO~
_\ '" "'. ," 0" ,.
""'~~1>'0~\,O
O"'ye~ 600 Amps or 1000 VS-!ts ~~2}" a~~~~0~
D. :~~ch Circuits ",.J1 f'.-Q ~ Co, 0 _ ...<a.oJ'~~'
O' ~'<I ><.....~ ~ ',0 ~l. "" ..',
New Alteration or$xteii'sio'ri'EefPa~10~ ,~...... 0\><'"
0' 0- 0..... ~'-J V ~ ~ r. ~
One Circuit 0."" 9:> 'If ~!:)O i~';;"O oS (~!,.43.00
Each Additiwl Gffi:uii%r~withuo") 0'."....& '. ~-
a....,.{',," ",'.)$300
Service o(.'Eeeder Rermlt'"' ~ ~ .0 '" .
y- ~O' r(~"",<61( ~'1> c,0 V ,,'
J '1\..,-,,~~"b.- ~.",x:-G,~.... I
E. I lVliscella~!:9q~{Ser.Y.ic~?lr 1'9t included) -Each I!,stall~tion I
('0- ~'" ~--0" ~;'
Pump or irrigati<5ilc:5 c,'If ~ C
Sign/Outline Lighting ('0'5
Limited EnergylResidential
Limited Energy/Commercial
1
$ 50,00
$ 50,00
$ 25,00
$ 45,00
Minimum Eleetric Permit Inspection Fee is $45.00 + Surcharges
4. t SUBTOTAL OF ABQVE '
I cOtS P'
\L\.C\\
~ 1.3D
r44.C\ .d. \
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding Forms/Electrical Permit Application l-03.doc