HomeMy WebLinkAboutPermit Electrical 2005-7-29
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" p CITY OF S"._dNGFIELD, OREGON "'I
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SPRINQPlaLD r~
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54H726-3689 ' ~-~' ~-.......~I
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ELnCTRlCAL PERMIT APPLICATION /; ;'Uf' g, and does noIr!qU, ctnJUe "the 10 owing
, b U Jif' 0l'9r- Ulre specific 'and use
City Job Number Co""z:oo:r-oc 9 -, Date 7 2-// (/[oOlng JttD~
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1. ;i~~IO;::::r;;T!ON~ ~ i 3. ~ COM!,~n_F!,E ~~~!~l:~~9:~~~~~ ~~a~~J'
LEGAL DESCRIPTION A. 'b~,e'wIieSidential ~ Single_or ~!~!ti!~~i1Y ~e.':.~',,:~llin!,~ni!'_J
170:<' Z 7 'J L( 0 Z 60? Service Included
JOB DESCRIPTION
1M A, Omff7 fJOwcx JJe.o.
1000 sq, ft. or less
Each additional 500 sq, ft, or
portion thereof
$106,00
$ 19,00
t
. Permits are non-transferable and expire if work is Each Manufact'd Home or \0
,^ not started within 180 days of issuance or if work is Modular Dwellinre.~~1,oe9 'io~,\,1W $50.00
Suspended for 180 days. Fee~ oregon n oregon \. \\ t\f\
2. !'CON!RACTOR:mSTAuATIOlorONi.Y i fo~~~i~~t?r~~;~;m~~~l(:"erations -;;;Rel~~~ilo;;~J
.. \i\ica\ion-eer''()o~O\I\ro~gn: o\\he (Utes i"{ /200
Electrical Contractor f...,i -rt; ~ L.t::::V7P2.I ~o O/'.R~\ obt~" CO?\es "'e \ele?hOn~ $ 63,00 C07 -
In 9"''' "'~" 0 400 1.Mcl,~', \\, ','ca\lon $7500
f J2... 113 0090, :,,1XM'\.~JR\<Il' 1.""1', \\\Ii~ l'l0\\' '
Address .0, ,..:/0)( 1 q call4ml~ftJg~~!32-2344). $125.00
"Ur6'oP~~\C\> il:jJt>d)~g;ps $163,00
City h../~f::V/? Phone 6Sfr-Yi1b Over't'BbOAmps/Volts $375,00
r Reconnect Only $ 50,00
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. fSwn:i:miL OF ABpV;;-- .' l 6 "3
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7% State Surcharge Lt t{ (
~ ,~IO%AdministrativeFee - b~o
~ ~ TOTAL 73 ?-L
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Supervisor License Number 3 ( <;3 S
to/OC:
Constr, Contr, Number ,C;Cj 7 Y-K-
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Signature of Supervising Electrician
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Owners Name ?fh,^ bc.-J V; {(he-
;:>/!,.." bo<-v
Expiration Date
Expiration Date
Address \ 2 '::>=
City So"'? r\-..
Phone
OVVNERINSTALLATION
The installation is being made on property 1 own which
is not intended for sale, lease or rent,
Owners Signature:
Inspection Request: 726-3769
c, f temporary Smi,=~..?rFeed!rs
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Installation, Alteration or Relocation '(...
. ,700:&nps or less "I'\\\E. It I \-IE. v-JO~~ $ 50,00
\~, \20YXmps tg'~60'A~ts\" D(.\\NlII \~ I'U' $ 69.00
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11-\ -401 Amp~t<1l600'Ainps ,,'\)Oi'ltO f\J\'\ $100,00
1\\,)1 t\\J\,\\L~ " ,,~ Ie. I\;\:l/'\"
C [)p'~er~!l!!I~~-\'J;WJ,OYolts s~e ::"B" above, __ -;-__
D. J Branch'<i:ircuilS :
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New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 43,00
$ 3,00
E. I Mis.ceIIaneous (S~rvice/feeder not incl~ded) -Each Installatioll~
Shared Drive(T:)IBuilding FonnslElectrical Permit Application 1'()3.doc