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HomeMy WebLinkAboutPermit Electrical 2004-7-26 "'0 <:1'/:. tfo '?~ o~ ~I"o ~ o~.;. ~../ ""0' ~.o · '~I~ fI,=iS=~.1) <to OO";%~I '?~ "Ol'~d'&. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-~ ~ . ""~0~6"q,j, ELECTRICAL PERMIT APPLICATION \I'~-:! ~ ".. ~ "0'1 City Job Num~fYld(JIJ4 - O()900 Date 7- d 0 - ;;>lJ1J<f "'",,,, '\. "C}~:~"-o1; I. W!Ja8\TIONrt' r-')fNsI,3tlfooI0N:~t7 rr""""'"'''''''''''''''''''''''''''''''''''' ~.,,, ,~"'~ -~ .' , . -~ 0", ~_"""'_,~~_~ ~ 3. .tSPkI1:'Jit-u;"itAf<'$.9l@.PJ1MJl!,EfP-, ;i, : ;ij -.~' ~ ~t (IJ ,:{_~ f!.11 LEGAL DESCRIPTION A., ~j'!~t@i1i~i:~~Xfi~l'fP~~il~i~.~t':~~@~ . '[71J< :din L/-:J. 0/90 <f . Service Included JOB DESCRIPTION ft)[) ~rLJ A~ ~ PermitS are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended fo,r 180 days; 2. C0~cJfORfr'NSTft:TlW:t'(JN;!oNfj}i;iJ .-. ,-., .<.,'" '---ltl:llb~tr~l~';{~'~~ . Electrical Contractor Address m ~\( ?-R 21 Phone (of'jh-SI/fI-lj Lf 7 f/- t.f \' J [j - ()/ - ('/-1 City Lv nO Supervisor License Number Expiration Date , , Constr. Contr. Number -1 t::i toJo I Q- 8~1 (f ~() S Expiration Date .Signature of Supervising Electrician ~/.~ Owners Name f!.~ c/!.../uz, C7.),r)' Address ( /?:(. ~ j/ ~a.>6 Q4L;f:- City ~tO Phone _.~. OWNER INSTALLA nON The installation is being made on Y'_Y" 'i I own which is not intended for sale, lease or rent. ' Owners Signature: Inspection Request: 726-3769 1000 sq.Ai:1'E~~s.ON: Or<1qon law reauires ;$106100 Each adffili8'l~~~"sqd'!,!9Bc.. UV t'1', Oregon Vtillty portio~~tOO'l\..a.{tion Center. Jhoc.A rilles are :$,19tOOh Each ~t!lliHo'k~ oQ01 0 through OAR 952-001- Modu1&il9~e!l'llig Se;;vice':lifliri copies of the rules by . Feeder ~ the center. (Note: the t\l'g~ B. i4~~N~W!_~ittm;,h:~~ ~ M~ ,,' ,~, ' "y~ L1.f'.'I...\'t~a""'HI~...~t-.~ $ 63.00 S 75.00 S 125.00 S163.00 S375.00 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps 0\~W.99~~psIVolts Rc!C(lJddCt'GD.1y $ 50.00 C rm.~,H~." ,~~~~L~~,"",A1JJX )~,.~~~>iW~,1~~.j'.!lki\,:!!,~' F1 'f>"'~:llo;;'~W~JDl;~~t9.." t!:~ " , ~ . " MMl:'NCED O~ IS ABANDONED FOR Instlinati9JJ, ~t~r~l!9!l~D~elocation 200 Amps or less S 50,00 201 Amps to 400 Amps S 69.00 401 Amps to 600 Amps S100.00 Over 600 Amps or 1000 Volts see "B" above. D iC';B-''llI'.:.IJ,u."",,~:''"'',~ '., ;.~I: ...: ~ ~,~~-; ,:_;~'<:t!:.. "0t>,7.,1ir.f.:,;.' .:~~;'" -0;. :,- ,'~. " . !:'...~!I~~.hl:.25S~t~ 'x".'-,.,..~~,'"j';:.' ",~.cr,J.,,;..;,,,:,..._...,,'i'j~,_, !:, 6~ " ""'~ >J'bC,.... . "'".''' New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with I Service or Feeder Permit S 43.00 $ 3.00 4.5,o:J 3.aV ~~"'~-E,;;,-~,';.#,:~;'~,s"'~""':n '~..:.,\l'C",,1 ..~_..:1'".<I'-'OP .,...t.t.'"~W~ E. ~~~$sl1~~s.:.(~~e:-m2sWJ~~!t\!l~~tpj:l~'!~~t:i.~~In;S}3~L~.~g:t!"~ Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial S 50.00 S 50,00 S 25.00 S 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~~~~~ ~':'f:i~':-'.~~;'~~lJ:~"":-"'~-",,'4' .~,t~1T."( -- ~ --., 4.Il'SUBTOTAHOF'irBOVE",'ii".!c>.u::'". '" ~~ v ...... ~.:"~~:~~?- ~)f.l;;,~"-:;!;f~"'<'.~t..:.:&~~~.;ol':~,._:r.,~# LifI!J I '3,,;;).).. q. . (/> CJ 1!S3.g'G 7% State Surcharge 10% Administrative Fee TOTAL Shared Drivc(T:)lBuild.ing FonnslElectricnJ Pennit Application l-Q3.doc