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HomeMy WebLinkAboutPermit Electrical 2006-6-13 Date L...DL- . o /(:>...... ZJ:sO~ 9PRIN"FI~()J~ ~ bftshb 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S4I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number .r.oVVl Z='c G. - 6072-'5: I. I LOCATIONOFINSTALLATION S "7 /9 12id&Cr,~-f v LEGAL DESCRIPTION f 8' 0 2. 0'-/ , l.f or -; ( 0 JOB DESCRIPTION J 1\ S-k II (' J1YI..\-v-n liAr err- ~~ 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 CONTRAcrORINSTALLATIONONLY I f, ) , U O~ uLJ 3. I COMPLETE FEE SCHEDULE BELOW A. I New Residential- Single or Multi-Family per dwelling unit. 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. I Services Of Feeders -Installation, Alterations or Relocation: 200 Amps or less . 201cAmpScto_4.o0 Amps Address j..) 7 r84-I'~ Ii IUI,: 401;Amp~to,~00 Amps '"'''' '_ , . ,I ,.. ~ '" 1/ 1 Ul...,. 60I.Amps.to 1000 Amps City e t..{A-. -'- Phone C:J, 'lI:~~o]J,J, .2cOver 1000 AmpsIVolts ~ Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Sig:tu~S~PiiSing Electrician . .l1.pdvv'Vi~., I ~ ( I ,~. ~_ . ill:I\J~~I)'~' ,',~; Owners Name V lD fE r '_;~v..~d~:-\ \~, " ,.., _I . ~\n'. I I Address .s 7 ('7 (C.-d; (~("' ,r" t- E. Miscellaneous (Service/feeder not Included) -Each Installation C;yf'h Electrical Contractor Supervisor License Number Expiration Date Constr. Contr. Number 7;;21 LI /Of3 ;/ 0 (p Expiration Date City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 c. I Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. I.Branch Circuits New. Alteration' or Extension Per Panel ,.. jllL.. ,,"- One Circuit \ c, . ,I; \'1 !-_-I-'-I"'1 . Each Additional Circuit or with Service~dr'Feed~r Pennit $ 43.00 $ 3.00 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential / $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges zS 4. I SUBTOTAL OF ABOVE L/ S- :;60 '150 55~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive{T:)IBuilding FonnsIElectrical Pennit Application 1-03.doc