HomeMy WebLinkAboutPermit Electrical 2003-9-3
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s submitted has the following
require specific land use
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FA'X~r{!l4'1)726-3689
ELECTRICAL PERMIT APPLICATION 0 Zoning L"Dr2-
City Job Number COWl ZOC] -G D ''is"'-f'J Date C;; ~ J Date e:j ~ ~... 0 '3 ~
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1. I LOCATIONOFINSTALLATION 3. I COMPLETE FEE SCHEDULE BELOW
bo '7 t4JW A-rI AVe
LEGAL DESCRIPTION
I dO 3. '34 L5,
0110)
A. I New Residential- Single or Multi-Family per dwelling unit.
Service Included
JOB DESCRIPTION
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
~10 '3
c. (Zc...<-^-I f"
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY I
$106.00
$ 19.00
$50.00
B.I Services OJ; Feeders..,.. Installatio~ Alteratio~s or Relocation:
orf-::~~=
bo <7 f4:,..---,4--1\/ in OAfE9r MiSeellaiieoiist(Serviell/feeiler'n'oriii\\luded) -Each IllstaIlation I
I)U::Iu. \ou may OOlaIn copies 01 me rUIl:1S ,
OS P.-'..o Phone 726 - br:7'b callin~uptP)Ohirrigati~i1lota: the telephone $ 50.00
numblSign/.QUtlinOi!Ji~htingJtility Notification $ 50.00
LmutealEiiergylR'esiaemiai'344). $ 25.00
Limited Energy/Commercial $ 45.00
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Phone 343-7297 Over 1000 AmpsNolls
NOflGt: \Rl\'F~t.,%@.K
J.\:lIS PERMll SHALL EXP p=;Ol
Supervisor License Number 2i?t,q:l1mRIZEO UNOER 1H'~D .. . .. .' Services or 'Feeders
OMMENCEO UK 13 ABAN
10-1-0~'IV 1 Rn DAY PERIOD. Installation, Alteration or Relocation
200 Amps or less
17252 20 I Amps to 400 Amps
401 Amps to 600 Amps
Electrical Contractor
"RP~7T'lQ]ilc: Fl 0(""'It-,...;,..
Address
2175 West 2nd
City
Euoene
Expiration Date
ConslT. ConlT. Number
Expiration Date
2/8/05
Over 600 Amps or I 000 Valls see "B" above.
D. I Branch Circuits
Signature of Supervising Electrician
Address
City
OWNER INSTALLATION
The installation is being made all property I own which
is not intended for sale, lease or rent.
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
$ 50.00
$ 69.00
$100.00
$ 43.00
1{3
(Q
$ 3.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
Owners Signature:
4.1 SUBTOTAL OF ABOVE
7% State Surcharge
10% Administrative Fee
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)!Building FormslElectrical Pennit Application l-Q3.doc
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