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HomeMy WebLinkAboutPermit Electrical 2005-3-8 Date '3/q/}~ I l'bv....>~. -"-0 _ _ _ ~____ 3. l.tOMP'ii::iEFiE'ScFli/iJ~;;;'.'EiOw .,. . ..' '''0;. "'\ I~,~.':-_.,....~~,.,. ,--" . '~"'~".c.',_,.~,~.., ..~~"., ,- ';,'". ~- -'1-.......-..-0---..,..$'.. ..i"-""...........-+~.. (.'i' """0 q..r '''.'''--,".,,,.mJ"'''' ,_".',~()~.._ _ . _1'''0._.--.-- ~t~ lS""a A. (,N~~:R~idenbal$~K"..(~;; ....I~:lli~,~:~~r;d'v~iti~~~~.~i~.. 1 U_\:'__.::J'___~",-",,--- --'J.....:..1S'.c.-0'~_............~.--...-J , '70""3> 264 (. 0 ( ') 0-0 Service Included <>'''r<> 3_ I~C}/~"" '\'- ",;.; &1,; JOB DESCRIPTION 1000 sq. ft. or less ~~ Ste6"~ ~ f".. \ ^ . ^ /-1 _'L Eac~ additional 500 sq. ft, or "~61 ~ 3~ . ^...() l :..V~ . _ CIIl.C,^, "--pomon thereof 19,00 . Permits are non-transferable and ex~ire if work is Each Manufact'd Home or " ~ ,. not started within 180 days of issuance or if work is Modular Dwelling Service or " $50 00 Suspended for 180 days. Feeder ' 2. I'CQ~d:()*lN$~Tt:1TtQJV'6Str 1 B. ~s.tr~ic~\ir'Fe~;Iers"3}~~~lli\i9-!'i~llerit[On.s -~;-Relo~~ji()n:::--l Electrical Contractor rfI \1 P If> ri- VI~i(} uJ \ IDC' 200 Amps orless ( $ 63.00 b '?, eP '< t '[) '\ L 201 Amps to 400 Amps $ 75.00 Address 0.).31 10 ~ €AI ~~ 40lAmPst0600~lyouto $125,00 . ~ ' I ^ 1\ . ,kr-cl.-ffi N' di%~\ltIt'd''fIi\\8~ffih.lti\ity $163.00 City 0i'lL. 'JljY... _ Phone .7 (}l{ JI~8"'i~s ~d~dllQO\~PPs~se\ torth $375.00 . r ( \.,\IOW ru \t<f.o'ijlttd~~ 952-00'. $ 50.00 . \'-lot\j\ca\iO~~~~ .OQ~j) thlOUg O~-{\I\ell..\)" Supervisor License Number ~ri"'=\ ~~OAP.,?~ mfJ btf';~r::::::I~%~~~p1~dDi1ld~~_ ~J v - OU'du,,'O \hecenter. tNOle.,~ N.otiflcation Expiration Date () c;- calling tor \~wn~t'lJi(jq{l or Relocation I " nUlllber ",,~d_Rf\n_~g2-~'. cent"vU;ltmlpS'tirTess Constr, Contr. Number <;(' 7. c:tj -b 201 Amps to 400 Amps ~ J r- 401 Amps to 600 Amps Expiration Date --:J. ~ " ()-V Over 600 Amps or 1000 Volts see "B" above. C-::::~---<:,""~"" --:- .- ---.--..........~ D. ~jjr~~~h "Gir~~its ',' ." '. ' , New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with- ;(1f\)\ . D <:> "Oi\CfService <?QU.dt'Kl'e,iJlijt\t1Ht: \N _ $ 3.00 S 5 PE~,^\1 S~ ~-1?-EQM\1 \5 NlI' " . .~" ~1\-\f;f\\Mi5.:~lI~lf.fs'Uf~~~mS~Se'dJt~t ;,ieluded) ",E.a:ch,I,ns'tall~~iilll.J ,,"H-lCEU un . co IVI\V' l)., . ",:;:;~Ir)n ~ c\I"Cl'AQr l"vgatlon f\N'< ~,gnfOutline Lighting Limited EnergyfResidential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is 545.00 + Surcharges (-~.. --~.--'--~---l ( 4. t'$wdpr1J,.());-N!ql;j- I.. .... " . _. ".,,, blO _____ _ .' . .-","-_.l"..._~~ __._5-~."~_.... _ '........,- I.(bZ- h 100 770:- .......... " 4">'-,....., .' . ,'" .",- I ". " ;:,":" .(..... f . ?,~"..r,.'. '. ',- 'CITY'OF S... .JNGFIELD,'OREGON:> ,., .:,: r <,1. . ,l "f .~ ." .' ,_ ." ,,", " _., . _" " ::.... ... .' . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (OM 7t"l() ,-06l..Sb r-'-~ ,""~' .___.;.......;~ __~ '"'' _ "..' _ ,,~,,:~,--:--,.---:'1 1. 't!::OCATIQNQPI1YSTJWLATH)N'," .,' ,; I n:5Ci" Q ~1>D LEGAL DESCRIPTION Signature of Supervising Electrician ~Q~Q ~~.Q - Sf L I ~tQS\ Address_ flR~ <( (Q~c.Q1- City ~ Phone Owners Name OVVNERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 7% State Surcharge 10% Administrative Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)lBuitding Forms/Electrical Permit Application 1~03.doc SPRINGFIELD ~~ . ,,,~~ , . I --' $ 50.00 $ 69.00 $100.00 .' , $ 50,00 $ 50,00 $ 25.00 $ 45.00