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HomeMy WebLinkAboutPermit Electrical 2003-7-28 '. '"~'::c:':'J' ~'):c'rn7:'a' 'F"r,~ ;-n..'G' FIEL"n aRE""~'G' a'N" ;~~. y- .-., d,''i ~. . .-:$>;- ',,," l' ~ L~."I\~ "-'_ _\-l.l'l ,. t', \ J. .,.,. .~ . -; <1-'" ,... l r :< ,.'. < +' l...~'1. " .. '-'l . _ '. ': _ "j. /' - . ,:,' ,. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726.3753 . F~J~~IJX26.3689 . . 109 protect es submitted has the'followlng ELECTRICAL PERMIT APPLICATION zoning. and does not require specific land use . /' / / approval. ClIyJobNumber COI41Z003-0C> t;:>f7 Date 71Z5jo1' . '''' /) I / ZOning 1_lJr <- ,I 3. l C(jMPLET~1;1Ef!t$€HE.Pl.4111>J.'.(CIWI.:At{.-o~.~ Authorized Signature "'ff/..tJ 1. I LOCATION,OF 1N8'l.'ALt.AiipN: 'I L/ 9 ?n./::-sc...d LAI LEGAL DESCRIPTION '7033. '-III JOB DESCRIPTION 066/ b ;4-bt.. Z . c.. I /Z.<..A;- f.... Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. I CqNTRAC'I'()RiNstALLATJON O.{VLY'I Electrical Contractor JZohS t::/~,-h",~ Address 2 I > S" 0/1' '0 J-I-, City (;"'1 <!.J,..(. Phone b f t- J,/ '-/ If If / tflf S' Expiration Date / () - D / - 0 'I ConstI', COntI'. Number ~- 1'1 b / LlCJ tj1-2.)'- 6'/ Supervisor License Number Expiralion Date Signature of Supervising Electrician PP< ~ ::z:::::...- Owners Name J.... d f 0 f f- Address 9'19 ?rt::>;co fI 1.# City '5f',....-"" Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature, Inspection Request: 726-3769 A, j' jS"" Res!d.ential- Single or J"1'!.Iti-Famil)' per' dwellihg ,/nit:' ., Service Included 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:i'sehic~s o~,Feede..s - rn~talla'tioll~' Alt';rati~ll~ o.~Relocalion: 200 Amp~ or less $ 63,00 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps ",.\'.0\$125.00 601 Amps to 1000 Amps ~~0~ '1~'U-;s.\~~3.00 Over 1000 AmpsNolts ~ ~0o.<S ~p.Q,0'~ q,llj"'~$f:i5.00 RecoIll1ect Only ~ \0' ~0 0 a~: 0.<:1 ~<J9\JO 0.0,0, ...,,\\1 _ t,s,G r'\~,. f> ~~ _,,0 C. FT';mp6ra'~~k.ie€~~fl!,~~"!'; ~',.:;.p'~:';S>.~ . S\ \- ~'" 0~' 0'11>" ,,\"'- 0...a >>"- ,.d(:,'" 1;.0~ ~ 0"\ ~PY - ~ ~O . 1~i;1II::gqU, ~feraA(6n 'k~~ek\'C'~o~~ ~~. 20Q,~~'tn-OO~~ 0'0 ~0~'~ O~ \j~f):"{; $ 50.00 20~~~ ~'ll>~~~~0(\ O~0~O"r $ 69.00 401 ii.,'!9-6P~~P$\('0 \~, $100.00 .CI 1:? ~\\ \0' ~\0\ Over ouO An'lJj.'k~iQ9liW()lts see "B" above. D. I 'Branch tJ}'tuits .. New Alteration or Extension Per Panel One Circuit I $ 43,00 Eaoh A<lditional Circuil or with ~~'?-:.'f.. Service or Feeder Permit ~;.. ~~qo _ ,<;."\ ~ ,c, E. li\tisc'lIalle~llS:(S'n:i~'!\.<ille'r:'iWt5i~IR~}'\.Each IlIstallationl . ~tr-\..\.- ,\'0''' ~S",..; Pump' ~~~t\W'\ S ~\::r..8' 'X>tr-~<;j $ 50,00 Si~~tli~,Et;W@g\J ()~ ,'0 ~\) $ 50.00 Limid';d"\?n~<;~ntial~'() , $ 25.00 ~"'b':;',,,,,, ::\' ~ Limiled Ene~/r^,l;'.wrcial $ 45.00 \.)V' ,'(is'-- Minimum Electii~ermit Inspection Fee is $45.00 + Surcharges ,. 1f3 '3 4, r SUBTOTAL OF ABOVE ' Vb ) '2"Z. !.j(,1? -SSKZ 7% State Surcharge 10% Administralive Fee TOTAL Shared Drive(T:)lBuilding FonnsIElectrical Permit Application 1-03.doc