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HomeMy WebLinkAboutPermit Electrical 2006-6-5 Date l-DL. NM SPRING"'I l .,. :AC .- ~ ,::="'rf.' ". ' 1':._ >.. .}_:_ t.h1 .;>,~;~ ,,5 t..")-oCq. ~ '::./"<'~"-""'~':"PT~r.\o"" ,< .;;Ti.fG' '~,in'"<o"'" . 'o"~r':: '.; '\ \- ., t.c;,- '''':.:t. ~ 'J 4\ ~ \:;.Ll>L: E'~.J.:'JXli". rI..I::.:LJ.:J'..'!.. . '1.",: ":"..' .~.." ,i'-.;:.-..",Q-." ':_;.\;,..,. ...'.... "",. "~~__":-' :;,'" "r~' _..... ~: ~~...;,l. '''';' .)~.....~... .. '-, 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPliCATION City Job Number Co..c-l?.o6~oo btfO ~""~l-f;\.'..,~.....,~........,~o_ ._ ":' ("';I~':C-O ._". 0........,- '::$ 1. 'ii.!ll~!J.Qf.IJjsrAg;~"lJ.9..N':.f;;, i1\;\J / S'I b C~,,,:,,,4-{ +- .sf- Expiration Date io - 01- D"7 ftl'l'j"f~:: InstaUation, Alteration or Relocation . THIS PE . 200 Amps or less $ 50.00 Conso'. ConO'. Number I ~ (, 7t,"'''TLin_RM1T SHALl tXR&1 Amps to 400 Amps, $ 69.00 CGMMEN~tU UNDER THtJo/:'.{fuPSi@ W~~ps $100.00 Expiration Date DJ - W- 0 IJJ^,~, ;uu ~:~ ~R IS ABA^Oei~~~~'~1il000 ~olts see "B" above. _~ Signature ozsupervi~. /tric~an ' R/GD. D. \#Br,!DclFG.!~~U1ts.. ;'. . ..", . . h. . '/~: > If- - - New Alteration or Extension Per Panel I /' ~ _ /f^./ One Circuit $ 43.00 / Each Additional Circuit or with ':'"') I I r" Service or Feeder Permit ? $ 3.00 Owners Name f<::v..;- '^- ,) ( R \ "" c. t!il_ Address IS" It::. Cid-""..."..&..( ~ s rE. 1:i\-1is~~lia!\eiu~iServi~~de:~~,~r:!i~t.incI..~ded) .,EiiSI{i."~I~II~t!iil):l 5:Peb Phone 7'/b -5.b'}J LEGAL DESCRlPTION 17032732. OO\O~ JOB DESC~Ol - _~:j:::::'L~,,~~~h .... not started within 180 days of issuance or if work is Suspended for 180 days. t.- ",'}~,,''''''''' "'1:.... ;',"j~""-...;..""'-~ ~_... ~~c,"'.';_....;~"..-"- ..:..:,,_., "r.'_' "'1 2. 1;~CQ~g9.Wpy.~r~!!.?p:IQJYl!lt!;X: Electrical Contractor Ihj-trA:I"< 'fa :I NL- Address .zx,' D ~}<'w:~.;F' City 5J{.,~ 0-0: Phone' ;7/-<;1..,0 Supervisor License Number Lj 7 7?. 5, City OWNER INST ALLA nON The installation is being made on' property I own which is not intended for sale, lease or rent Owners Signature: Inspection Request: 726-3769 1~"€OMn..,;l 'i.'FEE'SCiiEi5i:JI3i'iiELOW(. ~ ,,:.~:,"'>!/;~~' c"", ,1' 3. fa>,...~......,r_,.___", ..........~'.~.w"...'...I~:...,. .,--.,,~~a..::..", ... -~_~ ~~~;~~~~1j~F_';;"j"7':~~~~-=,.31i'~";"":r,~~~:"']f~"'A*,' ~-~~~~-1 A. iW~'!'l~~idel'!ilil'i~il]l:t~:,l!rlV!\!!!!iamily'p.!'!"gw~lJi_ng_!II!.& ',~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each'Manufact'd Home or ., "-"fr.. ~oaul1!'.DWeUihg.Service or feed",:1 ru!os "~ urena $50.00 fro ,:",. ,'Le,!,,..,-;- _ C-''-I(,l_'1#._ . n I[JI", "._. _... " ~... t;---/.t.-<..-''.....N,liN:;,.-'.;.','r:'!'...-'..+-J'~ _ ...... ,,'''-'', ;.I"~~'':.~~'i'1 B.1~~:tp'jc~~oBr~et!~!s~fi'~lh5.~4,U~J~o~.t'f\lt~~'1i~~S: 9!';~~~~~~~:' .~ _1 Calli,,~u~ tnall ,,'-i.1iO tn~~" rUles ,/,un Uiif",~ 1;200 'AiripsorGlessbtain C OUgn C. 'e $""1$63.00 >4/1I0Q,. ~ .... "l?n1-fj OPi '1119 ,,(JI11.. 201 Ainps't9,400 AinP.~'OI es Of" 52.nV$175,00 (' '" Qr. ' e. t. "'" rUh - 401 AinPS<t9.98<> ~P~I UtZ' tie Ir'~ e.~ ?~125,00 601 Amps to I&foCA1np..sJ; 'Iy No,,}:InOne $163.00 Over 1000 AmpsIVolts -23';4). '~"I/ol) $375.00 Reconnect Only $ 50.00 C. tf~!tfpora!'Y'S.n;ic~or;F~ei!~rs ' ,,,". " I ('. '.I ~j l(;3 9 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 4. ~irBTOiAr;'dF:ABOVE':^"', .,,:':, 'c,':1 t'" ? t";;...,.x~-,..,\;~".. - ..." ','l~ ..\:1.''';~:"",,:;'.:-../.!!1;~~'c, J L l>/. State Surcharge I.{ II:. 10% Administrative Fee > '.P=> "/~ TOTAL Shnred Drive(T:)/Building Forms/Electrical Pennit Application 1-Q3.doc