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HomeMy WebLinkAboutPermit Electrical 2008-10-10 ~.~ .....e6'(1.~~:\ . '!:J<:-"'410 'f:J>S ~...0 fb.? o..'V I. 1l.'t'Olii!m(b~. "-~~m~\'ffrilAmTb~" .~~'ll 3. flm.r,"'M-iit>jjijjjb)'i:;Jj.B~TiiiFin~- ': .0 "'-'.'-- illll:~,' ':',~i-:ri !i:~",.._~,~ !~"~ ~.:~th~"i' . , ;;;r;:",,~,,; !)ji:"Ci. \S~S \. '. _~L '"\ . f.\ ''''''J,R'''fal'-' !tU,;,~~~~~::"....:~~",. il(tli~l!>lZ'>;!E"':'t.t1 LEGALDESCRlF;r.ION ',f",,, ,.,."..".;,,\.. ,_ . -""";:t.'. l'i~ c t e t.lU I . ' ,.. IU!l'DdCll\~g!'!'!!F!~'J 17D..,?"'....,.),~?...., " '~.1'.'P.t"O' ~".:..",. ,!!~..,' :,,', , ",;-< '." ", ~,,'- "I, ,,0,' " ~;- ,.''7 ' ,<:.:~~,V-...:.;.>"(:.;..L>1,~-.,~.V,:;..fj:!l7;t ~,.'\t".~,..}'Se-rvlcelnclude'd. .".') .:: ,J:' .~.".~fl:b: ,,1,',' ,\ ~:~ JOB DESCRIPTION .~ 1000 sq. ft, or less ~1~.~ ,\{~t~ , . "$106.00' . Ad I I I C (.rr , . -\+c:: Each additional 500 sq. ft. or r'" 0. -r r ~,~ portIOn thereof $ 19.00 225 FIFrH STREET. SPRlNGFIEL ,OR 97477 . PH:(541)726-3753 . FAX: (54 ELECTRICAL PERMIT APPLICATION City Job Number ~ZoOr - O/Zz..1.{ Date 10 - 7-6\- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is - City Supervisor License Number .1_=>,q.,;;.S ..- Expiration Date If) - I - 01 Constr. Contr, Number ItJJlS/q . Expiration Date q _~ - ()(. Sig7c::ec~~) Q....11er; Name ;J~.., \fG-r.., F A'{p ^.J Address , I~' s-. IUrIN\ ~(I""~'j)i. City ':'\ ~P'\.. Phone ~ . S~) OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. O"11ers Signarure: Inspection Request: 726-3769 ~.,; . . ,',...;,. c, Im'i\tA"&"~'m~~~ Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 _4-~ ~ E. ~ '\uW'" e0-\'" ~\(;J (j0~\'" '\(\e 'O~\\V Bhm)b-Sr irrigJii~,,~ ~i\0- ~\0\0' ..",~ l\.$ 50.00 S~q':;0 -t~l\\" ",.R.1hu' J:l'O ~'\)\"'.n'?/'" $ 50 00 I O,." Q.1IlS-""lk-...Q5 ~e\' 00- . :''''' , L' itedtEnentylR~rde~t~e~(;J(;J''O'' $ 25,00 \\' ......~. .~' ~\l :\,u L. . (j'E .", ~'" ."1 $ 45 00 unIte . n<;rgy, e'cta . '" C:",. e" (\\<8' Minimum Elee~cif\P'errlilhnspection Fee is $45.00 + Surcharges 4. ...~ dZ..O ......q (,If Sd-o Lc 0 'i'1 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:}lBuilding Forms/Electrical Permit Application I-OJ.doc