Loading...
HomeMy WebLinkAboutPermit Electrical 2005-6-10 ",.,,~ ,,<!,.:;9rx,J~F,~r)I~~It:f.D, O~GGN',' ; ".. : 2~5 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION CityJobNumberCOM'Zeo'S'.Oc>704 Date h- '7- c':) 1. 'ZZY.1 LEGAL DESCRIPTION 170--1 ZbII JOB DESCRIPTION KLO~Sol4A' ort -6] 22. "7 j2e-puW' 3. tfOOMijl!Jl!1!f!J#l~Js'. ~ ~r.:l . 1i'~',,'",;-l.G '3 .",*' ~. / .. ~'" . 0~n.~' A. iii~~~i~~~~~Jt~l1l;iit~:W:t[i] -. ~___n:'"" _ __ _'~""'_ (\_'"~ _ .__~-.r....~...~~~__ Service Included 0" 0,>0' ....,~ W. 1000 sq. ft or less Each additional 500 sq. ft or portion thereof $106.00 S~(lV L L(:' $ s &A 11 {?,"'l!' I ir": -~"io-";'iJ~T,"""" B. ~"~~~~~~~~ifnfSl 2. ~' mwi~_Eb:ulna?:;.~ \\\'\:. .'- ~ Electrical Contractor CUI.CNc. t:1 E./ITP.JI'. SUV'lct.200 Amps orless' 'i:.'W\?'i:. \t_.~ \S $\~3.00 /2 b 201\Amil!:io 400 Ari1i>~\. '\\\\S 1'\:1'.':;' \-()I$ 75.00 Address 1.20 ;n"1II/CiJ6 ~. 4"df~~si6\6'06A;nPs'i:.? ,:oI\~\)\J\'~- $125.00 '\\11" ;c'1\-V u':-n \S t" 601.Amps,to'1000Jl-mps r\\) $163.00 Ovrr:looo~~slvoliS'i:.?\u . $375.00 \,V\'" .,...., \)1"'" Reconnect Only $ 50.00 1\\'" . C. ~fi~~Hk~~~~~ I Permils are non-transferable and expire If work is not started within 180 days of issuance or i( work is Suspended for 180 days. City tu~tN E:. Phone :3 '-I c.j - 3 (;' fc / Supervisor License Number ,3' 1- 3.5' S If) / / IrJ..O() +- . . 9tJ:J.OD 3/1r/Of" J,V Expiration Dale Constr. Contr. Number Expiration Date Siglialure of Supelvising Electrician 0rr~;qz:;;YI C7 Owners Name &/1-4 ~ II~. JJ(t. .t- . J20Se- 'KIOSo5>b.-. Address Z- ?l{ \ C;?F::p Phone City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease. or renL Owners Signature: Inspection Request: 726-3769 .. $ 19.00 Each Manufacl'd Home or Modular Dwelling Service or Feeder $50.00 Installation, Alteration or Relocatioll(lU\O . e(\\l\r9S' .\"" 200 Amps or lessegon \a'll r 0 el1{'n \)\\ ~J~O.oo ifte\QTP~'4ffi~b'l\ne ls~'Ase\'O 69.00 \~~b~Rl%\l~&Il!iS\ose f\l~ Ct.l~~ 95'2.-U~' 0.00 ~~~g It\~~~e'" DIrt '. ,',,- .'7~~;;~ no. can' _ \ \l.WI~~~~ Ne\!~I\I!lafl8n or 'a1e~tRH'e~~~I. On ~ \01 \\"Ie is '_\l00-:3:3~ Ea~ Additi!ilNiil'CJ.cuit or with Service or Feeder Pennit $ 43.00 $ 3.00 E. "~~',.. ...~~jU~;Yt(1,:t dI<t~/!~il' tr'~~ili tili,W'j:.r1 -::;l.~?j:ti'il-'it)ll!..' I Tl ~,t.....,_., ..-~_.l..}.. :t,.i..... '.._.""...,..... '.!'~I':."".... '~~"1'.....f. Pump or inigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial 5 45.00 Minimum Electric Permit Inspection Fee is 545.00 + Surcharges 4. . , ~... !l)..~ ,~:l:.;.--f:.\P .!.1.~.f. '~""-:: , '''' . '~.' '.<I.~' , ',. . , ~"r' 1 .... . .' rz,f:. '681. /7-bO /Y7 ~ 7% State Surcharge 10% Administrative Fee TOTAL SbaraI Drivc(T:)lBuildios l'ormsII!leelrical Permit Applicatiolll ~3.doe . ,