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Permit Electrical 2002-3-2
l)~/J.2,-()2 i':RI ")~:l~ F_~\: ~.'li2U:d3~. , 225 FErTH S~'R.F:.ET SPP1NGFlELD. CREGON ~7tl77 n-:SPEC,IC.S REQUEST, n6.3769 OFFrCE: 726..3759 ELCCTRiCAL l'ER.'\1rr APPL!CA TIOS City Job Numb.r 0 Z -00 II g- -0 I 3. COMPLETE FEE SCHEDl:LE BEl.QW JOB D.t:SCPlJ'TION 1000 s~.fj: llb~n~ - ~ cu.", -\-~ A Lll~1:DeIl.wir3 pmject as sUbmitte~!Pa!li&~ ,'()o oning, and does not reqUire sl);?f'I\'or pornon Penr~t; arc nO!l.tr.l.:l.for.1b1e a~~pllJQ:i1 C\)tV the:"of" _ _ IfworklsnmStarr~\\o1t!un 180rlays Zoning . ~ ......~..w.._.I.....UIIlt:'DT ofissum.cc Of lfwmi" is suspended f01 3.....d-~07 \ MO(~1I1:4ir........l" :: 180 days. Dale' ct<t.tJ Service Ot fed", , (). ,...MI7ed Sianature . C, C0YT?ACiOR INSTALLAfio}: ON! .Y- !l. Scrv!ce< or Foode", 7'l r . \ lnstalhttlon, Alteratiuns or Ekct.-ical COl\!roC'O,Ir't>\C.-SSI Of'Cl. RcIO<.OHoD: -:--:,... 'J "S<- '--'-'-'" hi AJ&= I-v pOx ~~%. Ciry ~c.Lnt;" Phun" LJS\- r33ll 1. LOCAl'WNQFL'iSTALLA11ON I _~3dd. (7G\.1 '-0("\ SIv'<<-'t l.EGAl. fJESCR1PTION 1702.1"75'7 05''70-0 Supel'liior Li"ns. "'\l.T-be, ,3982 i<f:- J E'l'ir.hon C.te _!_<?J 02- ConstrCor.tr, Nu:nb<.-r3lc \4l ExpirJthn. Ii<J;:- '-\ 04 I (\Lj Signature or SUflen'llilr.g EIHrrician f!Jfi-- ~~. O"nm~o!1l.'Ki Ilev \JC\\l~l}:u"'&6 Address?b IDI'IX dO'-j1 City (01"'"'0..\\\ ::;, Phon.SL\\ \ 7'-\Cl~'bftl OWNl:R INSTALLATIO~ The in::rul.:!:uion is being nude en p:-op~ay 1 O\',n whieb.lS not .:...,tcnd~:.:! fQr uk. l~rlse or n::-.t. Ownltrs Sign.uurc: . .~~:..' 190: (13IHSI;I8 :3SNI;IH8 SL'lS $ 3:Q83(1 lWI;I 3003 30 AI;IW:31I;lQ 36LBOOO-l0:#SNI;I(11 cn,' OF Si'RI::GFlELf- It tOl . A. N>c:\" Resic!enUal';sjnglc Of Multi-Family per dwelling unit. ' s"rvi.. hu:luJe<l: Items Cost Sum S105.00 S 19.00 S 50.GU :WO imps .Jr less $ 63.00 201 "'''P" to 400 ''''i'~ $ 75.0,) 401 .nlp' to 000 ""'I" ..~~25.aO_ 601.mps:olOOO=p, '(\'t.~~63,OO_ Om 1000 .mp,!\'oilS ....'t. \~"' ~~~5.00 ___ ;cor~ect :~l\. €f:;~ ~'t.~~~ ~ ~ ~e0a_ \\~~ ~~~~~;l~~~oc:~on \~~\~~~~~\\\I,)'\)' _ $SO,,,0 c.1,)~~&>~~O.a:;:' $69.00 ..tily~Cto 600 amps SI00.% ~\1.)-.....e'r 6fJC Mnps or ll}(){) \'oHs see "B~1bnve D. Br:lnch Circuits New Alt.:til;iot:. or EXl(ILSjOil P::r Pan~: OneCir.:,:il ,'0 S~3.00 .0\)', - "3"'11 ,.\\\\'l E3Ch Additional.ei~~:i[\~(~\'~ithlS~\.i:e Or Fee;er,p~~O\e;\e ,:>e~r:J::J\- $ 3 CO CJ\e.....o'o'l\"~\l\e':> ~9<;j' ':>~ - 'IV .~, E"(r.t;s.,.lt.6'e~11S\[Il,~,'\'k.1r~ not indu.:JeoJ' . \"~ '3,.\,).;.1.' ~ ,.- ......\v.. ~ v'- 0\'.... . r-1''C- \l\0':> ~\~ ~~\~t1Of<l':>O ~e~~ ~Of> ~\O~ \ \Of> c.~<!{'1P.Qj:, img~tf.\n..\'(\e \~o\\\\ca: _ !.\O,OO _. \0 :i.\\\c'3-\! S7:(S!g\'(gtJ:~~,gl~W~~'l IJ.A~' '. $50 nt; __ ~OO!>-~g \l\~h~lr,;n;;:~~:;1.t.~:?'2-'O IS2:.0v__ \f> 9\)'~0 \~!!,bte~JElergS@5mm _ $45.00__ Or;) ~\\~~ ~o\\~ ',:>"\- ~ c ~'Oe\~~"'~~l EI..h ic Permit InSlloclion Fee i $45.01) ,. {'IU: S.rcharges '. 45.cJD O. L"l d1A ?> ' ("r-, ::u 5 /.TS 4. SUBTOTAL OF ABOVE 1~;" State .s!lrc.hsrg~ g"}u Adzninistrative Fee TOTAL