HomeMy WebLinkAboutPermit Electrical 2005-3-24
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115.l'U HI STREET . SP~GFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)72~3689
. ELECTRICAL PERMIT APPLICATION
City Job Number CoMZ.OO"~ 002. "0.
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LEGAL DESCRIPTION
170S Z2.I'3 I \?3o 0
JOB DESCRIPTION
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. Permits are non-transferable and expire if work is
"not started within 180 days of issuance or Ifworkb
Suspended .for 180 days. .
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bate.
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Service Inmllie'cf rules adopted b He q res you to .
1000 sq. ~oti.tjmtion Center. Tho~~ iill~~ea~~~lity. \
Each ad~~~t56b'i$lr.Q\1b1J01 0 through OAR I Oor.l.
portion tiI€t'eof,.Vou may obtain cODi".. oflh~ 0 01.
calling, the CB t a es l.,
Each ManWarn'aS19lYf ,91 n Elf. (Note:. ~e telephone
Modular Dwellli1g-.s~~~e9pregon Utility NOlifJ",,-tl~
Feeder ~mer!8 U-60r 3E.: ~)~'u';W'"
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Electrical Contractor ,~( I \ d Jf.( ;tnc 200 Amps or less S 63.06'
I 201 Amps to 400 Amps S 75.00
Address 1S25 Wi/ Oy\(.~ Dr 401 Amps to 600 Amps S125.00
,I r- 601 Amps to 1000 Amps S163.00
City FtMOn.t . Phone21l..'-t-~7ib Over 1000 AmpsIVolts $375.00
\ Reconnect Only S 50.00
Pump or irrigation S 50.00
Sign/Outline Lighting $ 50.00
Limited EnergylResidential S 25.00
Limited Energy/Commercial S 45.00
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
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P<'.""'_"'~'~""J'"",".,..",,~~~~~J If I
7% State Surcharge -:> I{ J
~. . t\ \) ~ 10% Administrative Fee If ., 0
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Supervisor License Number Lf. 73+ -S
Expiration Date I fJ I 01 f 0 7
CODStr. Contr. Number' 2-0'- % ~ J/5b7f:1/
Expiration Date I 0 I O~ / <g /07
C:=fj::lectricmn
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Owners Name
~Y' 'f?,.v..Ft^ e:-tf-
80x 75Y7
Phone 17b~ 7f7b
City
70
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Address
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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Installati~~TllPerufi&ro~~I~~d~JS PERMIT IS NOT
L;UMMtNGI:D OR IS ABANDON~n F,nR
200 AmP~?I't19'l:ln DAY PERIOe S50.00
201 Amps to 400 Amps . . $ 69.00
401 Amps to 600 Amps SIOO.oo
Over 600 Amps or 1000 Volts see "B" above.
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NewAIteration or Extension Per Panel
One Circuit .' . I S 43.00
Each Additional Circuit or with
Service or Feeder Pennit
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b
z. S 3.00
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