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Permit Electrical 2002-6-17
190:;G3IHS\J:J SO'O~ $:39N\7HJ OS' GO't $ 1: G:J3;G lW\f GOOG b T Nnr:31\7Q 66S6000~10;#SN\7~i, 1 -. \. ';;', --"'" ,,, , \ '..,:" ,. r ' ! i. ,'r , i< , : ',"'- " . ' , }. i i., I' ! I . ELE.CAL PERMIT APPL~ , ' ' r' _,. . ;- 225 FIFTH STREET :", ,,\ 1'7': i SPRINGFIELD~ OREGON974771.__;' . ~. ',: "'-. I .... . . 1 .' ',.' "'," " i INSPECTION REQUEST: 726,3769 ,- \ J.' .9!Fi,c,E,:, 7?6-3759 ',' 1 \' ~ '"Il' " I ',,-, " I ',' ,,;\ ,'" I " .. ~', ..,,;:, ,'.. -F'; I r I 'L IjJ~4.rION9.f)NSTAL..k~TION ..' (CtJU:.5~ '1f1(,f:.j \A'Yr''-- :-'1 ..~-'; I; ! : I: ~":City ob Nun'ihe; '.' 0 z'-Ciot:...leO.-v I 'I I', !' r, ,l! I' ,'3.-COMPLETE FEE SCHEDULE BELOW qe 'I' I' I': l'... ""'~": 'iI.: N~';R(.identi;'I-Singleor ' -""--' Multi-FiMllily per dwelling unit. s~1ncluded: ' soll(l\i\\ed ;,~\'C i.."d 0 Items Cost "99<0Iec1;s<eIlO"e s9 '\'ne \OliO"~d does" I c.~~9~ I .,1i'~' 20","9 I=- LEGAL DESCRll'TION 170 L '3Lf3. 3, Sum,," JOB DESCRll'TION <;L-rL f L '- t..r $106,00 ,";'\ i; Permits are Ilon-transfcrable and expire if work is n?t'started within 180 da~le, 5i9"eW<e of issuance .or if work is suspended f%JlnO(\2ed 180 days. !\ ''e:. $ 19.00"" /~;- ,: ~'~.... /~$~~ $ 50.00 "" /.f:4.~~,,\ 2. CON~C:rOR INSTALLATION ONLY B. SelTices or Feeders ~ k~ ~ " J' ..' ' Installation, Alter' ,&~T-if _ . ,i, . ' ' Electricaltontr:lctO{.fll(p-:\~l..,~,. Relocation: .;Y~~ :?~{\, ..:; \ Address-lY(JtJq- ;tf/l1-,V\..St ~/, 200ampsor~~~~~'i 1"l6,~.00b3; ~ <.\,fJ 10]; / ~'. '''. 20 J anlPs t~O'a: ,.a ~ $ 70.00 CltY""f-II.~Phone_7J.&j7'~.@9 . ,401"~~ . tQ'," ---::$125.o<i~ I " ,. /! ~ ,',." 6~~~.~]~~ ---,-,$163.00_ Supervis?,r Licensle/NUI~ber )' /. ~ ~{ _:'. ,"~~ ^ '~ ~,,$3,?5.00 ~ I 'j. ',. "'\l'W:' '><, {::." ", Re~~. ,.....,.. . ~$,50.00 .. . ~ ~ ' "E' ~ :J; , " >" .:- '0 ,- ~~,;\t~V:0t~~:. ", " .' EXpIratIOn Date , ,# _ ~ ~ { ~~: ; 'pO; <if/" 0i ' 1\~~>dr~j1K,~"'?~ ,,' -0;2' ';~~Y,~2~~<,;'b_::. {~nstr 'C~nlr "Nn~j,er';~'18:i'i' ';: '1:.I~"f~',;I~~!;~,{i~:~,~l~€i'a:i~~:~~~:;JC;itiOJl~~;:51;\" ':'''.,~ - ---~~~~;~~:'~ :.1 _ :--~--)~~\~:~;-;;;:~;';>:/ ;;~;7>~::l~\;,~-;,$Q~,::,q~:r--';~;:;;,':i~~:,[~:;:-i~~:i,:+;~i;f~:~~~n~;:,~--:;,,); '" 'jJ_t,~_:~-i~),:',i:i~::;,'t%J '. ; " ~~Expiration Date '-.. <;:::c" " ,,' .,," < 'Y20?alujls or less.i:'.',,':';>$50.00 . ,"~ '.. '~., ",' . ""Zol,an,l,ps to'40oiu'tps';i., ":'$69.00 ,..... ""--...~. . . .....,...., .;:0 ,,', ,- " Signa.tureof ~upeITising Electrician -- _Oyer ~Ol to 600 am]ls.i"",~ if' ---'. $IOO.OO~' O,,~600 amps oi 16pQ)~ltS see: _, ~ ~! f ~. ' ......~,:-:--.. HB" b 0~-:o-. h~ M'<' "Q""""' - '. a ave .~ & c,-~~ ~ '~ ~<4 '" t\ ~ ro~ ~ro <i>v ~~:{;:0 {;: , I' ,,00<: 'lig;. <: _0 ",0 ; D. Branch Circui\~~ 0 ,..ro'" ()'f ~0 if' #' ',' NCW.',Alt,eratl&n~,,-Ex,.tensibii B&,]lanel ' I i' '~i.t;.<s> ~ ,::,0) ro'" - 0....~ ,#";j;;. olfe'cif~:it'V..<.~o ~."Ci# 0~~i!\$4,300 fl....: '&'~!f;' ~..<<v Cf.:y [1~' .:j.J 'Ii i'$ ~ ~~ ~ ~ l'i. ,Each,Additional,Gircuit,or with Service " ~'. ~ :....J C'\... C)~' '0' . "") (",..... ;:..or Feeder lJennit ,~&ro '1" ' ,$ 3.00 .... ....y ~vr!Ji .(;.Q-"v0 ~j' ..: - r*f1>,&"'~I:f! i"'''~~-;'''''' E. lIliscellimeous'(Scl:vice/fcedcr not included) G............; -.....4.1) xv s;:--- . "~-E~cl~'(ns~I,~aBOI~lO~ : .: Pl1i11~~~f{irrigatioh Sign/Outli"'" Lighting Limited Enefi,'y/Res Linlited Energy/Comm' Each Manufd Homc or Modular Dwelling Service or Feeder Ow~~rs Name IUJkP -~L Address;/rj'()()C::-' fWu0t ~+, , CitP~;; ~()Jcl . -'FEJ'j' Phone7J-(,,-,U f&> OWNER INSTALLATION The installation is being made on, , propcrty 1 o\vn which is not intended for sale, lense9rrent. $50.00 $50.00 $25.00 $45.00 O:;;{7;atulLAL rJ /, '. I\linimulll Electric Permit Inspection Fcc is S45.nO + Surcharges b~; i.{'f / 50'1 72 Lt,r... 4. SUBTOTAL OF ABOVE 70/0 Sta.tc Surch,arge 8% Administrative Fcc " ' TOTAL , ~-