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HomeMy WebLinkAboutPermit Electrical 2006-6-6 Date ~~ Car-^- OP~~ ~~I" h ~ S--o<;, - " CITY OF :~I)RINGFI ELD, OREGON 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (OwtZOOb -00 bo Z_ Serviee Included "Cl '\ 1000 sq. ft. or le~s~ ,\Q~\~~\ i!\'\ &J'~ ""is!..>) Each additional~500.~. ft. 'or "v L./ ;/;/1'1 q e/~c1r;,.1 ~/el> ;" bol1u5 roo,., portion therei\.i,\"t')v ~ r'~n .lJ:.", ,'()..... v ~\" ".". . ", -.../ (''\ ..'<'.e ,G"'~ f'\ -I ",:) Permits are non-transferable and nplre If work 1s~'.~ufll!"Jd'l;I~e 9!(" ,'~ not started wltbin 180 days of Issuan"" or Irwork Is _".OM~JiIar ~ellii),g S"{".i~ o!, ~"ffi $5000 Suspended for 180 days. -<,0'- <feooet\'<' :<0\0'>. e'" 0 ,,;" !if ~ . .<'-~, ",'il' ~?,\. ~r;:,'" cr:ft' ,..,e, .,c:. ' - 2 CONrRACl'OR INSTALLATION ONf,Y"" \~e~8Ja<'se~ic<ll'oV. Feeaers '" installation, Alterations or Relocntion: . -F N' 0" ~\ W :<t.., . 'o~Q ~ n.\! .,0'0 \ ~- !::-\.r n~V . , .~,c. <!J~~ ^~ _,e,' ~o ~~~ Electrical Contractor 'A~ 2- ,}90'1.l))ps~..less0r;:,' $ 63.00 /,,, O~r;:,~o ;!Q1eA'J1PS to",4W Amps $75.00 Address / ('P~ -t-'''~I'~~;tri600Amps $125.00 Co ,\\'<1' ce\' ,,~"'601 Amps to 1000 Amps $163.00 Over 1000 Amps/Volts $375.00 Reconnect Only $ 50.00 1. LOCATION OF INSTALLATION I~ 0.60 ~t'%. Avt!- <;.cy,~!:efd Q7lf'18 LEGAL DESCRIPTION 1802...033.'-1 00150 JOB DESCRIPTION City Supervisor License Number Expiration Date Expiration Date Signature iperviSing Electrician Owners Name 1'(l.{Cle J"1 I6rres v Address. hOBO 0"",/7 Av,.. City y,r'jRpJ) Pbooe .C;S/'-3Q3o OWNER INSTALLATION The installation is being made on ""0':) I own which is not intended for sale, lease or rent. OwnX~~~ 7 - . Inspection Request: 726-3769 3. COMPLEI'E FEE SCHEDULE BELOW A. . New Residential- Single or Multi-Family per dwelling unit. $106.00 $19.00 c. , Temporary Services or Feeders Installation, Alteration or Relocation ~ 200 Amps or less $ 50~~ ~~ 201 Amps to 400 Amps $W.OO.) 40 I Amps to 600 Amps . ItJ Q{)'oo~ ""'~' "- Over 600 Amps or 1000 Volts see"B" abow. i~ i~ . ~.~,,~ D. Brauch Circuits .l~ ~ . ~ <.(j ~ ~ New Alteration or Extension Per ~n~'" ':Q~ One Circuit _.:if ~ r_~$ 43.00 Each. Additional Circuit or, wi~~ ~ ~. 9:- ,- ~ . Service or Feeder Permit~' .;f ^ C'\. ,Q':$ 3.00 ~ " <<' iv' 'J ~v '.~ Q<<; ~'r;<<; ..... . E. Miscellaneous (~rviceJre<'de..,;'ot.i!JCluded) -Each Installation '. ~~~~~" . Pump ..~" "',s;, ;f ~ $ '0.00 or .mo._on '<:S ' J Sign/Outline Lighting (j .;t $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45,00 + Surcbarges 4. SUBroTAL OF ABOVE y, '39Z. '1<;0 S78Z. 7"10 State Surcharge 10% AdministJative Fee TOTAL Shared Drive(T:)lBuilding FonnslElectrical Permit Application '~3.doc