HomeMy WebLinkAboutPermit Electrical 2003-9-29
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:l(~a.j~iec'assubmiltedhasthefottowin9
d Ot require specIfic land use
ELECTRIC E IT APPLICATION zOning and oes n
n I "7 I ,/. approvai J.. -r-.,f2-
City Job Number Date ~I ~ Zoning Q'lL Q-!J..'1-()?
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JOB DESCRIPTION
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Permits are non-transferable and expire if \vo is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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Electrical Contractor 1<0 bS, E...kr ,)".1 (
Address ~ I t;''S ()}.,~ () ~
City ~"(\O Phone C.~C-'E/Nlj
Supervi~or .l-ice!l'\e Number ~ L/ 7 'f V s
wU I ,\Ii:. I\LLEP.IRE IF 1 Ht wunK
EXPiratMi\\~a~eE~~I~oco\..(~fI~fRMiT IS NOT
~~;~~~~~'L~ED v~~~t1NOj)NED FOR '
Constr. YGhlt."Nu r;rv (,., 5<'
ANY 180 '1\1 ..
Expiration Date ~ -f J ...... / 'I-oJ
Signature of Supervising Electrician
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City
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
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Service Included
1000 sq. fl. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling SelVice or
. Feeder
5106.00
519.00
$50.00
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200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
5 63.00
$ 75.00
$ 125.00
5163.00
$375.00
5 50.00
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InJfl\\2Wo~ub!t\~.ration.0'fR&gE.ati9illS are set fort
Notificatl n Canlt". , 1ll'l
20fO~r-HI!)~~01.001 0 through OAR !S~O.m,..
2B~5'P'Vl9J9Aa\JDJllllain caples ollhesrm!Oe I
4011:Wlfrl~~WM.'<!Plter. (Note: the tel~~_ .
, OVelfl600lMtip~6~lMO~IlPJkU~lly, 'ci'J>tlflcatlon
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5 43.00 ~~
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New Alteration or Extension Per Pan.....
One Circuit l
Eaeh Additional Circuit or with
Service or Feeder Permit
(
5 3.00
E. ~i:"1;,Wii8e~(\'"S1,,,fu\i..~_.,..tl,It.'\J'gI.~.rtfull~i\idid<)'f;'E~~-h~id~1~u.' :itl~~j
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Pump or inigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
5 50.00
5 50.00
5 25.00
545.00
Minimum Electric Permit Inspection Fcc is 545.00 + Surcharges
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7% State Surcharge
10% Administrative Fee
TOTAL
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Shared Drive(T:)/Building Fonns/Eloctrical Permit Applicalion 1-Q3.doc