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HomeMy WebLinkAboutPermit Electrical 2006-6-28 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION (i .IJ-IK.hJrJ S; - 0 ( 3S~ City Job Number ~ 1. LOCATION OF INSTALLATION :;:ltf:V .., . 8A-....u.I V;~ ~ '- 3~ ~ ~ 4ArY\ e. -_..1-u..... rr~'. ~ ~ . LEGAL DESCRIPTION I) 0 ~ 7- 'L- D60 I 6() 0 JOB DESCRIPTION 1tu,)'C' f' t....d. ~l'\ k A \ U. ~ ; I : -:J ?t A "' -t 1) 'b c... 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. CONTRACTOR INSTALLATION ONLY Electrical Contractor L. U. Me ('1' ; .. E.l-ec.4-.'rl~ Address '-\S'~ Shell.0.4 S-+V'f"o.&,.~ -J City S r (l ""- ~ (\ -.l.J. Phone; L.(., - 0 ~ II Supervisor License Number ~ 00 to S Expiration Date loll / 0" Constr. Contr. Number \ ~ ~ g Expiration Date t-I"i I ~i Signature of Supervising Electrician ,~ (/ Owners Name 'P 4q,e IlL U __ \ +- "- Address \ "2. ~ S \J. ~ l.... .::....-..:l .s 1-r,"c.+ ..J City E c...o..6 e H....a.... Phone ..., OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. 9,wners Signature: ',!IOTI['..C. - t., ~ i r. 1.. . n1J~ PEn~ ".' -- - I Il'iI; ~h;JlL EXP ~~n-IO_R;ZED UNDER y' " IR~ IF THE WOFIK ~IR~~Aq,!i&~C1{tN~~: IfP~-,tJ~ PERMIT IS NOT . 1 ,..r: :1. / p -. f\fjANOONEO FOR . u~" ERIOO /p - ;/6- (J t. Date 3. COMPLETE FEE SCHEDULE BELOW A. New Residential- Single or Multi-Family per dwelling unit. 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. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN oIts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 E. Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limife1l1ij!\t.rlr~i5ntial $ 25.00 LinfltOOBn!:rgW,~omJ~~@n law re4lL;rA~ Sl.dti-oo '-l D ~ 0 Minim~~,;iierl~ieINr;'~t~~~~~~nt~e9s!i~l:Jfffi;bargeS In, . '. '':: ~ 'C.U 1#}n i..t'-U.ln u e rules are set forth 4. SUBTOT;\LOF tJV.li,rough OAR .. .~. i'<'n!-',' 952-0..0.1 L{DS' t:J" c.. ,'0- ,elf I cO;:es of +h - . .. . ,'rrH'~.,,' , e HIlos b '2. 8% StateSurchar~~ ':_~I. (;\ :]ie: L'~e tel:=-nh" y 0)2." L{CJ 100/ Adm' .' l"'F ''''''r'~ , '."', -,~ ,one 41\ /0 Imstratlve ee':.c""u.:,I;'.I",I_.'., . "',~ . '.r IS 1.; ,'')r, ,..~..dL;iJ.tiOIJ TOTAL '~v'0,2-234(~). Y 1!l. 90 Shared Drive(T:)/Building FormslElectrical Permit Application I-06.doc