HomeMy WebLinkAboutPermit Electrical 2003-8-13
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FA-X: (541)726-3689 o,OIOc"o\ ,0<Yo D ~ 1 -
ELECTRICAL PERMIT APPLICATION / 10\\0"'~~ 600s
City Job Number L.olM 2003 -()07L/'7 Date '6/ 13~ 3 '\"~","~~:\ \,,~
. 1 t \00,0 1.0"
I. LOCATION OF INSTALLA110N 3. COMPLETE FEE SCHEDULE ; Ot~\I)'o
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LEGAL DESCRIPTION 1 A. New Residential - Single or ~l~lti-FamiIY per dwelling unit.
170-~Z.Z 13. 17 '700 Service Included
^~. ,':~..."" ' ::Jl"~> CI::fY, OF S" ~GFIELD . OREGO'N':: '.:.,?' ': ' .,
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JOB DESCRIPTION
Z. L' rL0..A \ h.
1000 sq. ft. or less
Each additional 500 sq. ft. or
ponion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
Hf IAl+
~
$ 19.00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is.
Suspended for 180 days.
$50.00
CONTRACTOR INSTALLATION ONLY
B. Services or Feeders - Installation, Alterations or Relocalion:
2.
Electrical Contractor
200 Amps or less
201 Amps to 400 Amps
401 AmpS~<llO@;mps
~O '~~i .
601 ~ps'l!f~!.'\! mps
~@~~d,0ll~ ~"sffblts
\'?Jo~ ~~m;e6rOnl)?- 0'" \.
o~ "" ~0'" . ~<?-'" ~I>~ 0
,Il . O~0CfJ 0 'Oi ,0 ~>S ....0 . ."(\0 ....O~. (\
Supervisor License Number +'U..... ~,_~\0 -<,'f<<G~ ;E~p~pr~~!~'!~or Feeders
f'!- _<<-.,,0 '?Joo" e~' ,,'S'~o ",e'" 0\0 ~'\'V
I ",~,,~ "'~ ~ ~" ~(\'" . ,,<,, ...\0. ,
nV' ,0.~. (J.'" lJ0 J:l\;) \~lnsta!!atlo~jA1tc;ri'hon or Relocahon
~. ,... ,. ~\ ....\0' ,~o ,~~ "n,Di
'O~o, G'?Jo~O ~<;:j .-I 0'" e~200 6\..nP~'l!'''!SS
.,,;$:-~ <;AC!J'fJ .~0' G0~'1cf.O~&J!!Pit0400Amps
'''': ~ or;.,,~ u:-. ~0 ~0 . ;1,6J'~mps to 600 Amps
, OC!J\J ~'O \O~ ~ ~
'" v":~ 'f:J~~ v0~\0 Over 600 Amps or 1000 Volts see UBU above.
~I>~ D. Branch Circuits
New Alteration or Extension Per ~~IlI~~,
One Circuit ~ ,'?I \$ 'r $ 43.00 y::,>
Each Additional Circui.l~~1t,\,\lI':\ ~~~ :3
Service or Feede~~rlnn ~c;, ~ ~5' " $ 3.00
!(;. i\ c;,~ &.'\' ,'?I ~'V'\S
.\)'(\'\~~~'hi~e{;?;~~eder not included) -E.ch Installatiou
~:\c;, '? a,,\1..~ ~'\' R)'V'
'I'~~~~~'?'t.,\,\l $ 50.00
~~i@~~~\)t;,)~ting $ 50.00
Li'i-~~ergYlReSidential $ 25.00 .
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
.
$ 63.00
$ 75.00
$125,00
$163,00
$375,00
$ 50.00
Address
City
Phone
Expiration Date
$ 50.00
$ 69.00
$100.00
Constr. Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name \2,4 P l.. Ace ( 1M C7V G-
Address s/70' \2,A.l,<LlNo.o.d
,
'3yFQ. Phone 77[,"03'11(
City
OWNER INSTALLATION
The installation is being made on propeny I own which
is not intended for sale, lease or rent.
(~8~
Inspection Request: 726-3(/
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S3 SZ
4, SUBTOTAL OF ABOVE
7% State Surcharge
10% Administrative Fee
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Shared Drive(T:)/Building Fonns/Ek'Ctrical Pcmlil Application 1-03.doc
TOTAL