HomeMy WebLinkAboutPermit Electrical 2003-4-3
:' CITY OF S:" _.JNGFIELD, OREGON .
.., .
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FA.X: (541t.!~3B89d~~~e~~~~:qu~~lts'ed hBfS ',hefOl/owing
app I pecl IC and use
ELECTRICAL PERMIT APPVCATION rova . ~
City Job Number c.. ") -QO (0 b Date Zoning
Dale <4:' <3--,' '?
"j 3. ICOMPLETE,FEESGREJj)LILEI~!:y". '9'fuJ
"IIIOrICt:
Supervisor License Number ~;1~'t1lip'~~ .
~'ll?tr
Expiration Date . 10/01/J#l!lfIl?.t:IlEO {l,SIi-4l( E. Installation, Alteration or Relocation
}> 180 'CEO 0. ~VEI1l; ~P/Ij>~1tAmPS or less $ 50.00
Constr. Contr. Number ---26-14~ 0-4y /),. 'Ii /S -dlllitS Pt, ~1l~1Jt to 400 Amps $ 69.00
"'''100 [4NOOM 1'flfl,~0 Amps $100.00
Expiration Date 10/01/03 . ~~o1'~ps ~r ,1000 Vol~see "~:'..b~ve.
Signature of Supervising EleCln'Jci I . D. l' B.raneh,CJrcul!,>. ';.' '~ '
/1\ /J New Alteration or EJ:tension Per Panel
T ",,-TV r.h"1:'11"n _ LA _One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Permit
1. l,WCATION OF tNST.ADLATION:
5 erN PIA W'-< LP ..of
LEGAL DESCRIPTION
,g--OU:>3o0 DOb60
JOB DESCRIPTION
I-Io'^-<::.e lllfU/
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. ::(;QNT~cTOR.)NSTALLATION)ONI:I'1
Electrical Contractor J:hr; c:te.DS.Cr' 14'1 t:!J.(" tl"'; ('
Address
l?qR Rpthpl I),-;"p
City
Phone 'it. 1 -hRR-h 1 ?1
Fllgpn~
Address
HAVdf:;7V'
~O t!.tJ Y
<; {J Fb., Phone
Eivr
'683
b?t-7 'lot
Owners Name
City
"
OWNERINSTAL!,~TION .
The installation is being made on propertY I oWn which
is not intended for sale. lease arrent. . . '[., .
'-
._r
A. I New ReSidcnt!~17 Single or Multi-F:imily 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
I
2
$ 19.00
$ 106.aO
lOb
3%
$50.00
B. I' Servic";"or,FeWel-s,::' histaUation, A1teration;o.. Reloeation:
~ - ." '.' , .' ,-" .. ,. - ,
200 Amps or less
201 Amps to 400 Amps'
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsN olts
Reconnect Only
$ 63.00
$ 75,00
$125.00
$163.00
$375.00
$ 50.00
, ""., . , , .. . .
C. I'T~mjJOr.ry Services or Feeders
"'..'
t,'
t"',', '-1
$ 3.00
E. :~~~~~einJ\Se~C~/i~ed~rnotine"ud~d)'-)!.ach'lrst.llat!on I
Pump or inigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
$ 50.00
$ 50.00
$25.00
$ 45.00
"
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
,
I,: (' " !,~. __1", .:__"v ..- . ,...,' , ..... ,.,
, 4,' S"'.n,uTAEOF,ABOVE "; , ',',':
. t,'..., '," -". '.' ...... ',' ! '-"".-,< . '" " ,. _._'~'-'
.' 'f,
,'I
I'll
100fs
" ," ",," ",. 7% State Surcharge
10% Administrative Fee ILf 40
'~''"''''''''~'" n"'''' ~~'b~:' TOTAL 16$~k
~ ~ ~ \ ':J:J:J Shared Drive(T:)IBuilding Forms/Electrical Pennit Application I-OJ.doc
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Owners Signature:
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