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Permit Electrical 2002-9-17
~ 225FIFI'HS;rr<E.ET;' ., {"':[:-!"- " ELE.CALPERNnTAP~TION '. SPRINGFIELD, OREGON 974771 .. ~ j' _: i : .'; ". . ... .' , INSPECTION REQUfST' 72'6,:i~69 -', ".J :~~ ! i :city'Job NumbeD 2 - (!) /{f (,cO! .j j (~fFI,CE: 726-3759 . ,~ :. i I ,J t~ fit.! ! : !' r , '.' :;., ;, . '. : .: : l~i i~: ,'3. COMPLETE FqE SCHEDULE BELOW \. , I ,I LOC~TJ.QN,OF~NSTAL'ATION tJ . !I ;', / i ..... j ~. II ;u-."I;--'tU..:;,::llvu...) 1f');;).. ,-,-_. A:. New'Residenti!lI-Single or Multi-Family pcr dwelling unit. Service Includcd: " . i ',-," LEGAL DESCRIPTION 1703273/ CObO 0 Items Cost SUI)l . I ,< JOB DE,sCRlPTlON 1000 sq. ft. or less JI1I/ It 5{:-il.J1 ee- C rf-Arl/cr,c Each additional 500 1 The. following pro;ec! as submitted ha~\l,.f1rc\1fo\J,ortion Permits are non-transferable jB~r~fft.RP does not requirE? specifi~~Lselng if work is n?t'started within I 80d'~vs, L D (l., Each Manufd Home or of issuance or if work is suspended fofomng M.udJ.llm Dwelling 180 days,.,', . Date C( - \ 1- n"2. Service o[~eeder F' ~. Authorized Signa,ture 'M -A<S'<$.~O~'" 2. CONTRACTOR lNST ALLA TION ONL Y D. "d '-M> ~'$"'F..~cLs 'i:>~ '0'-" , In)tallilio~ A'it'[.gti~ns or '\ Electrical Cont~actor DIXON ELECTRIC. INC. ~<R~ljc';.tit;.)..Q)- ...:~: t:.' >::- ..' .. ~~, ..HI YV MARTIN... ,'ti ~0 ~0'" 00:;(-" ~0 :!;~:Jj ~o . - \.., .( , il 'CRESWElL, OR 97420:/' -'" 0<:'- .\~....,...'> '" ~~ ",0'i.~<Jf . ,~ " \ I~ lli41)89li2HO/' " c0<:$ o'020.,'a~s~Cles~\&,. ./~$,63.0~i :.. /;',",;,~".b.. ,.","\, '".0: '2FX amRsfto.:4(0)lmos'" ,," ~'$ 75.00,_. ! /"",-.,0<<\',,:, ~,:f\ -,v!iS n"< ...... ~ 'b( . -- City I Phone .//:'.>;"'},:". O,,)".0....4~1 aDlps,t!>'~O'amps .":$125.00 '.. \ ,J / "",,,","'IjR "';",~ ...0/..."<:': A"" .' . 1;".""" \ .., (..' 0~0"~oOh"nlJlSt&.,luev'alpps, ...,;.$163.Q<l_ Sup~rvis,ortj~~n~eINu.l11bbr. AtJt , 'b~?~%JjW~01ojj.~Y9~\S . . ~ $F500 -2:.. i I, .,1., V, "';;'., ~ t.><[f"~~~n Iy"".",.., , ~ $'.50.,20_ Expiration D~te .. -j'O,- ;~;;;~. ~1lJ ~ .' ";';i ;'" ,,,. ,;,,):' i // <, " ., C""T!'So,~ S' F d ?" " /..::" .. \"" l' ~,' +<. '.,L l. <;0,; ~,y7x . ., .~.mllQra~. enrlcesor ce ers~ +"', ;;~~ 'Constr_Contr. NU~lber 0.. !OJ ~G:{. ~',!'~1s~lla:!~n, AIt~ration or Reloca" ,,' .~, J , ~ '. , r ~,{ C;..~. '", , ";'.. <', 'i .Ji;:i ". ";\.- '-.... --_ Q~~'-"'':-)~;;."' t:'-"::c~-",,;..;.t'f<"~"~ :.~" "~: P1\;:~" "e'-l1';"<llJ '~/ ~,~ ..~, ,I ~'>.E:pirationDate 1c--'I-!i;i{J~.' :":~. : i','; ~' "200a~lIpsor1ess 1,;'-; :~~:/l.'~~ $50.00 . . . .~--~, 201ampsto400a~ps'~:-~'7~$ ""i; $69.00_' . i Sigl ~~ cgf~ujlervising Electrician --~O.V..eL...401to698~,,~1. i:'4f'~;i'~.',.,',"!'/.ii''0$.I..,O..O,..'','O,'.o,,_'' " . . 'i ,,', ,} .,'. .. ~ Over 600'amps.o . ~.~ ee:J';:i[' '. ~:~~~,i^;"1' ~~'~~';i;',_{~" "B"aboxe .;y'~~~;~,'c~ ;":~~> ,,"4'~~k ........-.". ",' . ': "., , !~\ ~ ~ "i' t' ,: ,.;'..... ~R' I' , "\t\ \ \ \ D. Branch Cireui~ ~ ~~. I d.. ." owners~.~:yiGU.i\..\l~"~\o\~~ \ New~~'!S~r~onpe/pane! .".:' ... '.:','(::t.((, ~> ("'.. D~ ~~~~ ~ " ; T Addre~JJ~ ,\,~\,r-Qw\ll. \1 ~~!?1~~.$~~.~$~.300 _ p~,,~.. '''''' "\I! Y, ~~~.A..~ I ~, . City.;~ .'~. , pho,ne.,",) .-:\:,I"' /1. \)~ ' ~:~~~~.~~,!~~t Circ:i,t or with S~rvi~: ',3:00 OWNERTNS ALLATION ,.' ! i:,:JF';-- / '_, "~I , ~.;,. ;,. .,.... .,' ',' .";'. ", _',j r I ""_"',,-"'C.\' ''',''~' \"",: ' , The illsfalla~i9ri isjJeirigmadeori' . E. MisceIIaneou~(Serv~ce/feedcr not includ~d):;' property Io\vn whien is not intended :. f-Eacllinst<111ation' '..;' \.' " forsale,leaseor rent." " t; P;lthp'or.:i'r~i~ati6h " . \$50:00'" '-', . .......,..".,;r -, - ;!, $ignlqutIirie Lighting $50.00' ". Lirhited'EnergylRes $25.00 : ,Limited Energ)./Com~' $45.00, .-..,!"/ ,;l' ,- , , l\'linimum Elec!ricPermit Inspection Fee is 545.00 + Surcharges " I t ',~ . I' - \, . ,- 00 4. SUB~O;ALOFABOVE; SO~'- J . . 7%Sta,te~~.rch;arge' ,.':,' )JO '-4.',,~\ 8% Adniinistrative Fee.' YOu TOTAL \ / ' '$ 5753- $106.00 . . '., 1'[ .... J.'- " j / .~... $ 19.00 ,. .....'2.L $ 50.00 yD.; \. I' i Address , , . /.. I ! ! \ ! t .': I ,. f l. ! t. ' 'OwncJ:s' -?igna~ure: : :- ,. ., , 190:~mHS\KI :39~~H:J Olj'W $, G:a:J3/f1H\i 6002, tJ:; d3S:',3:1I;JO, :;:1:90100.., 1O:#SNlffll 1., . I. ..\