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HomeMy WebLinkAboutPermit Electrical 2006-4-12 ~ -. .' Uf2- Y'\ 1'2-\ d.p ~~ . e ;"R,:~QF~~:-'~," '0~ ". 'l"._~M:~~ ) 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FA-X: (541)726-3689 t;~::-,>-;, ~ifJ'~~;~ ELECTRIC4/- PERMIT APPLICATION ",;.::'::2'~ "iJjJi ...; City Job NumberlO'r'nLODS - 0\ 02S0 Date 4 - 12.. - Z. csu<;;. I. "LOCA110N OF INST.4.LIATION. . 15\5 (gu'~d_~' ,. , LEGAL DE~.!!:T10N \''103 -~I 3~ ro 15([ I '. .,' "" ..... ", ".., ."A.. ,':' :','_... . '. ,. "... " .-,., ..~ 1. "\......,',_~ .. '!l""'.' '~h 3. .:. COMPLETE FEE,$CHEDULE BELOW'.{t.~,,:"f:'::{"'."~, \" . ...;._'. '_' . ..."'......_.....u "" ......_,.~.,.'.,.r..~.,...r~.'-I;'.:::...,...~I~ ." ," '..~..:.,~,.';'"-l.,-....-~..'\.: .. ....;>o-;q'\...~.Hr-.'.',r...,../....~:..... A. ~ New Residential.- Shigle_or.I\lulti-Familv-per dwelling' unit: !~ .1 .". '."__ '_ . ,_ . -', .,;",._..,':':':..~....' _. '~""'_"':""'''''''h_ ~~~;,.,..tl.",..... _ ~:,"~'.:;:' Service Included JOB DESCRIPr9N ~O nd- 't'LUY\ f Permits are non.transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1000 sq. ft. or less Each additional 500 sq, ft. or portion thereof $106.00 City r!.A,.,., tU~ J / Phone f'9~ - 'Y9/,d- $ 19,00 ~ ~ ':' 'lor's you to Each Man~fact'd Home or , :':~ G. 'i 'on Ul.lily Modular. Dwel1ing Service_ or F d ,.1. ,r,,:c; ;;,$50:00forth ee er ':I'.'':_':>~.' ,!..;~...; .'...,t;<t:: '''<.'0' ....~_~.'-~~-~~~..Q,\,R~\r~.9L;f~P3.1;::.~.-t'..':"':. B. Ser\'ices or Feeders ':'lnstilllation;'Alterations odRi!lo'c:ition:~'.., :......;. ':k ,~~;;;',:;.' ..... #0':'" ..;,~.~_. .~.. r.......:(J:.~t:le"i"~:cpfit)ne :.;.._:"~':~- :~, 200 Amps or less , .: (,'c,jOfl Utdl\v i$:63!00.ltion 201 Amps to 400 Amps'ur ib 1eUO,332'23$"~5,00 401 Amps to 600 Amps $125,00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolt, $375,00 Reconnect Only $ 50,00 '._' :, ..1'.... . ,',,_. -,. . 1."- or-':1'. ~. ". 2 ';CON1'RAcrORINSTALLA.Tii5ivoNI_yJ . '~o:o 1. ~ ~. ..'... .' .:. .....--' ':::-"1' -,.:""_":~-!...:".... "0 c.,.:.:.:i ~,_~..':I.o.::....'X- Electrical Contractor (!" ~rJ<.t.uS E:./~f~c. Address f? 0, p,,,,>< / / 93 Supervisor License Number :197 t) - S .....,''':...~:., ..'ll'~:~',~";'''''.J,,''~':\-.. ;'.,~. ...,..,...,:.. : '::; ,...y~ '-';':-:'.".n'-""~-r~'.n-""M~"'~--:-'r? c. ~.,T~~jporary .ScrYice~ ~i feedcrs\.-;:-',,~,,',"~.\~i.:.~,"~,,~rt :*.....~.. . :.~~~!0-:...:- '::::~lt ... .,. .. 0'0_'-""0'. .. ~~. .a.......... .....j~_ ........__. ...._'>-f.......~_,,~r_.""".......:.-;.;.'-,.t;.__.:.;;;.> Expiration Date J t) - d /- a. 7 Installation, Alteration or Relocation Conslr, Contr, Number /5: 'j S, ~ 7 200 Amps or less 20 I Amps to 400 Amps ''';~':. 401 Amps to 600 Amps "'-.... -. ,; nM/\iIT SHAOver600f';"pso~ 1?,OOVo~:,see"B:'ab,ove: ,,_', '. . C' "~'~;:.':Z'{?~2~ . ;;~:!;\~e ~!i~ll*i}FW;:;;~:;~:,'oo":':~~ ~l~ ~ . E~tH Additional Circuit or with / '=> i L. ~\ Service or Feeder Penmt $ 3.00 ,.J Owners Nam \\~.\..Q..J ':! Address \5\S W. ~ \ \ r6 W E. ::.~li~~~n~~e?~;(~i'r~!~e,i[~e.d'~;:~i;'iii.~I.~~,~d)~.i1.~~lnsiall~t~o,~, Phon~1 $ 50.00 $ 69.00 $100.00 Expiration Date _lJ -, /.5 - O? Cily2iQ~ tv OWNER INST ALLA nON Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee L/0 . aD 3,~~ 4,00 6~ . ~ '( Owners Signature: . ., ".' 0 0.'0 o",~.J.: ,,0_ ". '._ , . 4. i SUBTOTAl. OFABOVF;''''. " ,': \ ,'" . . "'_. ~~ '>. '; I ..::.. ,,,,,.,.., ,'.' Inspection Request: 726-3769 TOTAL Shared Drivc(T:)/Building FonnslElectrica! Pennit Application l-03.doc