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Permit Electrical 2002-6-20 (2)
" '. ,"225 FIFTH STREET :,', '. . \,', SPRINGFIELD, OREGON 97471', f' INSPECTION REQUJ:'ST: 726:3~6~ ' I ..OFFICE: 726-3759" d 'i f i~~:':;"~"' ;':I~~\:~:';: e,,! . (" ',c' ';,;,,'; L"'r [, I. LOCATION OF INSTALLATION ~1:':'(o~;tiJ,. o;;ti: ~ '. , ELE_~1 PERMIT APP~ - ',':::',,:,?:,:y,.>/r,: _ _ '-:_:_,_:-'t:"::~','_'-'1>:" CityJoh ~~:I~~r~6Z....:(xx):bb_'TO( E.: I'J r _ :.' .'':,'''':;:>'-:.<-.': 3: COMPLETE FEE SCHEDULE BELOW ~>':; ; ,,_,__ r .. .. . .....-.,.. ..., i' ,I. ! I [,..: l' _ / ]- -', ': ',' ,"'\..,~ _ A, New'Residential-Single or ..' Multi.Family per dwelling unit. Sen'icc Included: , ......, ~.,..... LEGAL DESCRIPTION f8'oZ6bLfZ- D050/ Items Cost Sum ~\O",illll as \.\,\e ~~.u?e JOB DESCRIPTION ,\\eol',"e \aftIVU sq,ft. or less n r,<:, vie ll<ll' ee'" , , _ 'Uri '" ~ -' "",(l. L '==" . .~ sll Me sQ Each ad anal 500 '; 'f\9\,>~o\e~o\~e~u. orpo 'on " ,"'\\\'!'~';';.<\oes Jl , Penl11ts arc non-transfcrab~~'.."",~- J:1 ,'"':.. the if work is not 'started withinLI:8(Il'~,& ~ 1-- ach a Home or of issuance br if work is susp&l\'i\~d fOrz.Ollillll. 0 - ular Dwelling 180 days, ' Service or Feeder '. ~e .". \)9.\0 S\f~f\a: 2, CONTRACTORINSTALLA~6@~~Y $106,00 $ 19,00 / $ 50,00 Electrical' Contractor' B," SCI"yiccs or Feeders , Installation, Alter~iions or Relocation: i ~ ;' >,.)t.. //(')':> 200 (Imps or le~s/ -"'i:S:' ,:'(" "'I." ,:r$'63.00 _ ' " /<i,'JA"i 20 I amps to 400 amps' .... .' .,t$ 75,00 City Phone ('.. ',<", ";,:' 401 amps to.600 amps,.:f:~' ---.: $'125,QO , , \' "60Iampsto'I000amps, ,$163.66 supervisor~i{~nseNu91ber, A"j, . , " O;'er 10<\0 amps/volts '~~\~\.i = $375,00 . r i.~,' r//.' \:::7-, . . :'. :Reconne',t9nly~..~~~~:,,~-'-:$ 50,00_ ',,,~. < ^ "',; """ K ~ ":"7~ ""," ~"'*0j' :4~'<, ~ '''^()''''''''I:,\V I' I' EXPiration!:>at.",~ ,< " '. '" ~', /', :..~'''' : "'~_,c" '~rf.",e'~, '" ,:,; t . ." . ....:\L!..'..t~\:{f.:,\~: c.;_~t--7~_<<-,-"' ;; ~ ~:' ~~n~i)~~~~i~-~Q'if;-s:~~~e~g~~~\Q", ~~~~, ;:~ Constr Contr. Number " . > ., ." , Install'lhon;)\;IteratiO~,m;..RelocatlOn AI' "~" ' ~ '~"-<-1ij.t;.,." ::~ ~~'~,j,,,,,.~'g~~i.~~~"~Q\:;w.~~O'''', ~~ t~ ,. ,''::':Expiration Date '-< , , ,', , , f\" ,...\il~~100 amps'1Or l~s,~~~'I!l..,,\<< " , $)0,00 ' - tb\W.... ~~~. "f'\{'\\ .,. i,?~ ~ _~; ~Kt~v - I - , "--:'.__\*'i,c.e:p.?lV'a~w~to~~ ~;a~Pj(~),;.A')" i'~"$69,OO_ ,;Y:Signature of ~uflmising Electrician ~~OJ".~9,Yl'f.'~q1<,to'~&.;n1J''k''''f'~ '---.: $)00,00_ . .. ~ '~n9\)' g,\'ct:600\~]l1P\'!r{~000 volts see ".,; 't y :',;'1->:." ~'.... J i~'B,'i:'a66~,i ~\C, ~ ~~ ..f)." . ': . C 'lJe., l0\e ,', "" ,\v,('0 0~ \ ' , ,'. , . '0' U L - ,t 1 D. Branch Circuits . " Owners Name\<O't':\ t:Q..Q(:!()-t1\a' Ne':' Alterati,on or Extension Per'Panel , ,Address 'l....s.0I' I ?d\A~V\ ~ On'~ 'Circuit :1' Cit)~ lrl Phone 7 LJ I-Lf0f3J- E~~l Additional Ci~~~~~rvice ~. or!iFe~~~~~~~\li\1~~i _$3,00_ \\\\~ t.~. ,(S"1)"i.~~ hot included) ,,,,, ...\t~\)~ l\St$&~)l"- ~'\~" ~~lQl M~~tlOn $50 00 Q~~~~ ~Tt1'ne Lighting $50,00 tj~",'C \y.\) united Energy/Res $25.00 1"" LimIted Energy/Comm $45,00 Address , , I $43,00 OWNER INSTALLATION The installation is being made on property I 0\\'11 which is not intended for sale, lease or rent. toO'>3I_ ~~~qJ : 39NtJH:J g~'2L $ Z:a:J3~ lW~ 2002 02 Nnr:31~a LL96000-l0:#SN~1 l\linimum Electric Permit Inspection Fcc is 545.00 + Surcharges b> Y 41 50'-( 72-~ 4, SUBTOTAL OF ABOVE 7% State Surcharge 8% Administrative Fcc TOTAL