HomeMy WebLinkAboutPermit Electrical 2018-10-04Electrical Permit A lication 3PaNOa.€l.D l]il?nt*?M225 Fifih St.eet.Sp.inelield, OR 9?477.PH(541)7163753.FAX(541)726-3689
Tbis permit is issued under OAR 918-309-0000. Permits are nontr1ansferable Permits expire if work is Doa started withio 160
days of issustrc€ or if work is suspeBded for 180 days,
',.:i . i .'LOCAL-G
Zoning approval verified? f] Ves E No
/Residential E Government n Commercial
JOB: SITE lN
Job site address 80b5 lAuci tJ
city,5t"..,-.d,.R* 0 fl State: C)e zrP:qN7B
Reference Taxlot
Name:G-
Address: ({JQ fu)<-
City Stut", CE ztPc-17q1 7
Phone Fax
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(l) and 479.560(l ).
Signature:
IL c
city, RidA l+ce zDtqT+bg
Phone: $fJ 874- {3^7 I Fax: -"34-rt-ts,
E-mail c tx
CCB license no.:l1rl3,BCD cense no.:5lA1S
Signing supervisor's Iicense no.: 5W7 S
Print name of signing supervisor: COAq 5. H6.Ck-e*
Signatu.e of signing supervisor: Cd
Permit no.:IB-oo b"\
\oDate
NudbeiroJinspectior's rpf r iteh (
1,000 sq. 11. or less (4)$181.00 s
s 3s.00 sEari:h additional 500 sq. ft. or portion
$ 43.00 sLimited energy (2)
$ 86.00 $Each manulactured home or nrodular
d*,elling service or feeder (2)
S€rvices or feeders: mstallation, akeralion, relocation
200 a.rnps or less (2)$
201 to 400 a.rnps (2)s127.00 s
401 1o 600 amps (2)$215.00 s
601 to 1,000 amps (2)$277.00 s
s635.00 sOver 1.000 a,nps or volts (2)
$ 86.00 5
Temporary services or feederst installation, alteration, relocdlion
200 amps or less (2)$ 86.00 S
$'r18.00 S201 to 400 anlps (2)
$172,00 s
Over 600 arnps or 1,000 volts, see services or feeders seclion above
Branch circuits: ae\r, dlleratian, extensioh per panel
a Fee lor branch circuits with purchase ofa service or tbedcr t'ee
5 7.42 !Each branch circuit
b. Fee for branch circuits withou purchase ola service or fc()drJr lee
s 86.00 $First branch circuil (2)
5 7.42 $Each additional branch circuit
Mi6cellancous fee6: ssrvice arfeedet nol included
Each pump or irdgation circle (2)$ 86.00 $
Each sign or outline lighting (2)$ 93.00 $
s 99.00 5Signal circuit or a Iimited-energy pa,rel,
altemtion, or extension (2)
(A) Enter subtotal ofabove fbes
(Minimum Permit Fee $99.00)
s99.00Each additional inspcction: (l)
$
s(B) Enter 12% su{charge (.12 x [A])
$(C) Technology Fe€ (5% oflAl)
5TOTAL lecs and surcharges (A rhrough D):
Last edited 7112018 BJones
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:TION
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Business namei bn..r , rf I
Address: Rv 3 -: t .1.
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State:
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FEE .SCHEDUtE
Totalcost
s 109.00
Reconnecl only (2)
401 to 600 amps (2)
5
Rcsidential, per unit, seraice included: