HomeMy WebLinkAboutPermit Electrical 2003-1-27
" . I .. · . s submitted h~~ thO following
~- rsquire specIfic land use
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~!I\Q:}l~ 2l?-~689 _/7
appro'&"At. /l1v
ELECTRICALPERMIT APPLICATION _ Zoning. ~1' ()y
CityJobNumber Ct>>rzooz..- 6/3/ / Date O/ZL(03, n.te / 0J
I. I LOCATlON OF INSTALLA1'ION 3. I COMPLETE Ft~~a'i'E~lf}rE~ELOW
b S-7 ,/Jf./A'_A'o/'" ./f'/
LEGAL DESCRIPTION / A. I New Residential- Siugle or Multi-Family pH dwelling unit.
1703s5sLf ob 760 Service Included
Electrical Contracto~,,(;j h, /t~ ,lE;t.~/c.. 200 Amps or less OU \0
'. 201 Amps to(dQ@J~~\)\i\i\'l
/j)Y'U.~/LL> ~ ~o~~{igQ!)~Glr~se\\ot\~.
r ~ \ IO~'.l6~\85bIjl~ ~'e \QlJO~S3<:>2'()~ "0"
City,r-' ~5 we.t- L- Phone ?7S~- S}~J (u\e5 'c}~t'.s~ .rOO8~jW6~(\e tu\e e
~\O'~, C~e~Wro~, S 0' ~o"
\~\\~\C'c}~~2_{){)'" ",\a\\'\ co1;.~ \~e \~~~\ca\\o""
J 2.:z.R ~"Op..~ '10u(i))~~,\wpo}d~~\\\~~k~~'feeders
99'tJO.. ,\'IJ ~ Qtl:l'>!v ?,'5t-'?v
/0/6/1 2 007" c'c}\\\~t\l[lI~r.~~.!iill\'i<)Steration or Relocation
\'IU~ QzO'd'~mps or less
12']77 201 Amps to 400 Amps
40 I Amps to 600 Amps
06
JOB DESCRIPTION
~,4&L I 'I L1 (" '-'-".: ~
Permits are non-tfansferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2. I CONTRACTOR INSTALLATION ONLY I
Address
?333y
Supervisor License Number
Expiration Date
Constr. Contr. Number
Expiration Date / z
2/
Signature of Su ervising Electrician
~
v~
,Jjj~cj&f
7(
Owners Name ~'"
Address ?.; <lS6)C
City sf(LI~t=eJJ Phone
OWNER INSTALLATION
The installation is being made on property lawn which
is not intended for sale, lease or rent.
Owners Signarure:
Inspection Request: 726-3769
1000 sq. ft, or less
Each additional 500 sq. ft. or
portion thereof
Each Manufac!' d Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19.00
$50,00
B.l Services or Feeders - Installation, Alterations or Relocation:
I
43
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50,00
$ 50.00
$ 69.00
$100.00
Over 600 Amps or 1000 Volts see "B" above, -I
D. I Branch Circnits . ,tM.\)'<"~
~""... "'1\t;:)
New Alteration or Extension Pe&~n.l~ \~ Q.,
One Circuit ~~ n(".Q;..~", ~<9\f3,OO
Each Additional Circui~'\..~~' ~y / l
Service or t~~er 1\e#it ~Q;.. ~ ~\)"r $ 3.00
I ~,:~> ny~~~\\~~~J. ~~ I
E. l\.f'1Se~HY'e)!:usJ~~I.))~~~"'not inelnded) -Each Installation
\' ~'(o.~ ~"''',I '("
P .,\, .,'\-. <"\~, $ 5000
ump or.tmga.tiOll !\l v .
Sign/Outlin~Ligfu~g , $ 50,00
Limited Ene~~lResidential $ 25.00
Limited Energy/Commercial $ 45.00
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
4.1 SUBTOTAL OF ABOVE
7)
7% State Surcharge
10% Administrative Fee
r-
-,>2.)
75""0
<f;77r
TOTAL
Shared Drive(T:)IBuilding Forms/Electrical Permit Application 1~3.doc