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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 vAL.-.' 1 :TION , iDES(iK ,k- Business namei bn..r , rf I Address: Rv 3 -: t .1. -L) State: t no-f ".b&, FEE .SCHEDUtE Totalcost s 109.00 Reconnecl only (2) 401 to 600 amps (2) 5 Rcsidential, per unit, seraice included: