HomeMy WebLinkAboutPermit Electrical 2007-1-3
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""-W A!.. , DATE 1- 3 -0'7
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SPRINGFIELD
.'~~~~, ;'::CIIYbE~$~~CIELD,:' OREGON' '. ' . .
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54t)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
,-
City Job Number COlNll-Co7 -0 oc) , S
Installation, Alteration or Relocation
200 Amps or less $ 50.00
) ?o 1f?':'5' 201 Ampst0400Amps $ 69,00
,.., ''-I,. '_. 401 Amps to 600 Amps $100.00'. "
~- '?& __0 R!.~'.OWflJ/f:iSa'd~'O"'LcO'600A 1000 V I "B" b
-""(,"at" Op ver , mps or 0 ts see a ave.
o lOne 1l:it:1h'J" ':''1U!It:::.y
Signature of Supervising Elecnician '~R 952 en.Q,~ ;BrancIi16'!.~Ults Ou to
SJ )090 Yi -001-00<' nOSe fil', l:Jflon Util',
fJ' ~\ c: ,. Ou may New.Alteralion,or,ExtensiLiil Per Panel
. 1 a/, Ob " "'1VuC!h .....et~
-.. VV. ~~ mg the Ce tC0ne;Gircitit OAR952 Ort!
~-., ;:Jl:if fOfthenter.EaChidai~i@fal'.Gircuil-Q.'1\Iith
O "'ow Tr - tUff': $ 300
~ ~ r;f). re~OfVice'or'Fee<%,Pennipbl ' .-.---.,::".,.
Owners Name "- 0 S ~ p, .ntarts 1. -.. Ulillt"N '.Pllone-< :
8(lf).'?:1? 'J otlfic.' , .' . - - . - " -..--
Address Z- '3 r G:. ~ ~t:v c...~ E, Misceii'.h"9~s (~~"iCe/feeder not included) -Each Installation'..,.,;'.
,/~- . . - .-. ---' .-. -, -.
'5?,c\\
Phone Pump or irrigation $ 50.00
,.....
, .J I it:E' Sign/Outline Lighting $ 50,00
OWNER INSTALLATION' II'S PERM Limited Energy/Residential $ 25,00
Th. II' 'b' Idl'.r~,- IITCC"'h'h L"dE /e'l $4500
e IDsta attOn IS emg ma e onlpJ:Op~ OWD1't' Ie IIDlte nergy ommerCI3 .
. . d d' I I ,,," ,,< tV UN I.. t:XPIn.,.
IS not mten e ,or sa e, ease OTj.~~rtv OER '1~li,l)imum Electric Permit Inspection Fee is $45.00 + Snrcharges ',+' c.:".'";,.'
- 4Ny I I CEO OR THIS p IIiF fAf,,_ "bJ
Owners Signature' BOD4Y /S484 tA?/v,SUBmr,.MOFABOVE
. PE NO ,'11 /S /\In
RIGa. GNED~ro Stiiie'Surcharge S"O"'l
16&}J Administrative Fee b l' Q ..
5% Technology Fee , ,)-
77 LfJ-
I. LOCATION OF INSTALLATION: 3.
-2356 M4 C7 .
LEGAL DESCRIPTlON:1;O:1 Z. 7 Z. "Z. 0 3 700A.
,40/J/./V>E ;; Of!..iAo I ~ ,fJ/kt.JEjJ
JdB DESCRIPTION:
~/AU:' flt-oA-t: (
Permits are non. transferable and expire if work is
not started within 180 days of issuance or if work is
Suspend~d for 180 days,
2.
CONTRACTOR INSTALLATION ONLY
Electrical Contractor V ,/l-/?JS "'4 J4.A/ ~ser
Address / ~ a.-e. I) t:rI.Af?..-.&--P ~
City ~~f1tJ
Phone '1 $' y. 7,':;,f'?
Supcrvisor License Number .:=( ?St" "
Expiration Date. / t') _ ;- 0 ')
Constr. Contr. Number
Expiration Date
City
Inspection Request: 726-3769
Date
COMPLETE FEE SCHEDULE BELOW
New Residential- Single or Mnlti-Family per dwelling nnit.
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:
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolrs
Reconnect Only
j
'J"
$ 63.00
$ 75.00
$125,00
$163,00
$375.00
$ 50,00
c. Temporary Services or Feeders
;:.....
'-3" .
'. "P::~.:.~
1:..,:- ~ .
,-.':t.' ~
$ 43.00
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TOTAL
Shared Drive(T:)/Building Fonns/Electrical Permit Application 8-06.doc