HomeMy WebLinkAboutBuilding Electrical 2020-03-02Ie ctrical Pe rmit A Iicatio
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fhis pgrmit is issued under OAR 918_309_0000.days of issuance or if work i, ,^p.ooro iriiio ffffot are nontransferable. Permits expire if work is not started within lg0
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Zoning verified?approval
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Job site address: 206 S Ash St
State: Or ZIP: 97477
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dResidential I Government E CommercialJOB SITE
City:
Reference: Record # 8 I l-19-001 1311e;O0l0l
new home
ZIp: 97478
Name:
Address:
Raymond & Leora
87686 Cedar Flat Rd
State: Or
109Phone: 54J sz 4
Fax:
E-mail: lbailey52@aol.com
Businessnamrt hrvls I I L I
Address: 31,o1t
Crty:State: 0 (L zIP: i'1tl?3
ptrones{l-5f{ -SZq q Fax:
t4Q5E-mail:@
CCB license no.: lOgll Qr BCD license no.: /j.g t-
?.351 S
supervisor:Print name of
Signature of signing supervisor: fr
Number of inspections per item ( )Total
cost
$186.00 $
Residential,per serviceunit,included
1,000 sq. ft. or less (4)
Each additional
thereof
500 sq. ft. orportion
$36.00 $
Limited energy (2)$44.00 $
Each manufacfured orhome modular
orservtcedwelling (2)$89.00 $
$
orScrvices feeders:installatton,relocationaheration,
200 amps or less (2)slr2.00
201 to 400 amps (2)$13r.00 $
401 to 600 amps (2)$221.00 $
601 to 1,000 amps (2)$285.00 $
Over 1,000 amps or volts (2)s654.00 $
Reconnect only (2)$89.00 $
Tem orservrcesrporary feeders:installation,relocationalteration,
200 amps or less (2)
s89.00 $
201 to 400 amps (2)$122.00 $
401 to 600 amps (2)$177.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase ofa service or feeder fee:
Each branch circuit $8.00 $
b.Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2)$89.00 $
Each additional branch circuit $8.00 $
Miscellaneous fees: serttice or feeder not included
Each pump or irrigation circle (2)$E9.00 $
Each sign or outline lighting (2)$89.00 $
Signal circuit or a limited-energy panel,
alteration, or extension (2)$89.00 $
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102.(X))
Each additional inspection: (l)sr02.00 $
$
(B) Enter l27o surcharge (.12 x [A])$
(C) Technology Fee (5% of [A])s
sTOTAL fees and surcharges (A througlr D):
Lest ertiteil 7/112019 BJones
OFCITY oREGO N
Cost
GA.
feeder
fr
USE ONIY
Signature:
Signing supervisor's license no.:
hrrr, Waoa*-
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