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HomeMy WebLinkAboutPermit Electrical 2006-3-20 c.c...- project as Sllbmine'Br~AIia 101g~g oesll1l>l're<;utJarsp~~ J'sa . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-36l11kllng ~~c ~evnj ELECTRICAL PERMIT APPLICATION Data j- " ~ "'- City Job Number r.() W\ roo S- - 00 17 g I Dat~._", ,,~.t.z.fcd;> I. LOCATIONOFINSTALLATION 3. . COMPLErEFEESCHEDULEBELOW _lOrN P/)f~{ {.A)~LS;rij..f{,'e{JiJ. LEGAL DESCRIPTION A. . New Residential- Single or Multi-Family per dwelliug unit. ~ 170 s2 Z 2..D 02.(;6"\ Service Included r. I I \ ' - CITY OF ~:,,/RINGFIELD, O~EGON ,,/ :. . , 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. Signalure ofSllpervising Electrician D. Branch Circuits // A./7 NeWAlteratiOnorrr,~~~el / 4/.// L - W;)1\C~: One.5AA~t. EY-I'IR ~~t-/I\i \~ \-\~, $43.00 - ~ <:; ""t-A-n,F ?,ML'^^- i~IS !O\:~~';~~~~~Q~~~Q\\ $ 3.00 Owners Name , 'I:: .,. t.\\ln C\:O 0\\ IS~tl Address a. <.or 5M- +e- ~ ? / A ~N\N\~ \)~1{s~~S (Service/feeder not included) -Each Installation ..-./ yI f..1~'{ '\ 8\l Cii)t.!fOO.......,;..J- Phone Pump or irrigation $ 50.00 '307 - 7bG - I..{II(, Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25.00 I '1/. ^,,- Limited Energy/Commercial $ 45.00 ..,:> .....- ~ JOB DESCRIPTION IJoi lA- d-IX~ ?&.f"lih~ Pennits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. . CONTRACIOR INSTALLATION ONLY 2. Electrical Contraclor ~td! I-dlcr.,,'1! ~CJ Address ..:; 01>D ~ e (4 B Jl.. (+lJoiL. City PDI'H~ Phone S";>?"-ZPS-f7l.P Supervisor License Nwnber C;,,?, L.€:!:5 Expimtion Date /6 - / - 0 R Constr. Contr. Number (., 3 b '11 Expiration Date 1..-/5'-07 The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $19.00 $50.00 B. Services or Feeders -lnstallatin"1!;1\llerations or Reloclltion: . \ W reC\U\t"~ - -\i\V . ,,,,,I' Oregon a egon Uti 1 . ^:Ti~O"Amps'or lessdd by the Or _ 00' torts 63.00 ,.... InC "OOUl ules a, - - .. 10\\C40t~~~~~'h'l9~ t\'11Ps:e r h Of.':'. ~C;?-00~-75.00 "o\il:\.OIl"'mps to ~OO {'<.!I'Ps oug . \'_ = ",Ip.S \$)25.00 I' _ cc;?_001-UU 'es o. ,.- in 0.601-Amps to IOQQiAmjiSl\l1 t_'onhOne$163.00 vO'bN3,,/ u ".' te' t\1e -. . oogOver-l ~'!, 1'IJP,~91~'0 '.. t 'n.;fica\\0~375.00 cl&~Co1!n\!ctOhl~ Oregon Utility 3;~) $ 50.00 number lor tn<J is 1_800-332-2 1 . C. ~ T~!!Ip(G~rse~i~es or !~e_d~rs Installation, Alteration or Relocation $ 50.00 $ 69.00 $100.00 Minimum Electric Pennit Inspection Fee is $45.00 + Surcharges 4. , SUBTOTAL OF ABOVE 8% Stale Surcharge 10% Administrative Fee ~,~ 'f.~ 5"3 e TOTAL Shared Drive(T:)lBuilding FormslElectrical Pennit Application 1..Q6,doc