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Permit Electrical 2002-7-12
":)1.b 30 ':I~ I ~ 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQCSST: 726-3769 OFFICE: 726-3759 EL~ "UCAL PERlvIIT APPLICATION AJcrl.\-t.-n jb.' , ,', , ' City Joh Numher OJ.. -DO~ 31- 0 J CONWLETE FEE SCHEDULE BELOW 1. LOCATION OF INSTALLATIO~ I"'.,...". ..'.11 3J. L:> r ertA6t\ rt I' il ~ v t'R . LEGA~ DESCRlPTION - n IJ 5' , "-" ~ l I yt,. VVL J tLIL.t. c-lo,;, l- A.NewResidential~Single or Multi-Family per dwelling unit. Senice Included: Items Cost Sum ~\(\Q; . JOB DESCRIPT~QN J~~#:1.ft. or less rJ: V' -e~ M., ~ (U1 <:'~ ..I. ~'3-~ \~..Ji~~h additional 500 ,\, - I ,eu .~\G ~i-\'" ,<>~eG\ sq, ft 0 rtion Permits are non-transferable and expire \ '3-'<> ,<>vc..~\~e tl of 'eG ~e if work is not started within 180 days . ~ ~~o\, (\0' 1) Eac anuf ome or of issuance or if work is suspendecl ~of\(\ oooe II. odula welling " e~ ~ OV 180 days, '~~ ~\(\(j '3-' (\~ ".~ 'J" S ce or Feeder ,/-0 ~~~oy, 1,0(\\ 1 ~ v.; o;'i 2. CONTRACTOR INSTALLA:lflON ONL ,Jl. enices or Feeders Chri~tenson Electric, Inc",.'(;.,J>. :ei~\~(\'3- Installa~ion, Alterations or Electncal' CQntractor_~te1~..Jl ~~" ~).temS RelocatIOn: i~0'\.. $106.00 $ 19,00 '. -' ~. $ 50,00 Address 1298 Bethel Drive City Philips f) (',' D. k~ll L- )C 1wJ. 5 Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit -1 $ 3.00 9 J)1J Owners Signature: ." "E.. JWiscell~ll~?Us{Service/feeder not included) , (;; .' , '~Each installation , " ',.\~" '::Fi:~~'p 'q~. ittig~tion $ 5 0 . 00 " ,.) \. U 'SigI,if.,OuHrtte Lighting $50.00 .,~'-"'\\~\, ..v.', ..t\Dl€.l~ted:~nergy!Res $25.00 ) ,.' ,,' \";:Li~~t,,~ Energy/Carom $45,00 . Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fee 5,), olJ .3 (" '-I tf, , I,.. TOTAL ~ ~D