HomeMy WebLinkAboutPermit Electrical 2020-03-12A3/LL/2828 E4: 46PM 5417458812 STEVENS ELECTRIC PAGE 81./87
aI Permit ation !FFta{oFrfto
xls trftb Eteeto Spriuliol4 OR 97 117.Pll(S4l)7rG37$afAr(541[2egdS9
Thts permlt lg lssued under OAR 918-309-0000, Pcrmltr *e nonftrnsfereble. Permlts explre llwork is not rtrrted wtthta t80
dryc of imuance or if work ir mrpended for ltO dayr.
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CII'Y OH] ST'ITINGFIEI,D, ORE,GON gu -3b-
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Zoningspprovrlverified? E V.s ENo
OF CNSTRT
E Coverament
It,,Altt
lob site address:
ciry'5f fuWffiD Snie:@ ZIP:
Reference:Taxlot.:
o
Neme:
Address:
City:State:ZIP:
Phone;Fax:
E-mailr
This installation is being made on rssidcntid or hrm properqr
owncd by mc or a membcr of my immediatc family. This
property is not intcodcd for sale, erchange, lease, or rert. OAR
479.s40(l) aod 479.560(l ).
Sipature:
tsuiness neme:,\E
Address: fo 60 X t 65
c*y(laqnf .tlilt Statu@K ^?q7Brpnorc;5w-^7-la-
^a_ro
r*flrl-r/16^ 68 /7
E-rntr;ffdlGtJLeOW aln
BCD licensb no.:C I 16lCcB license
license no.:
Priqt name of
sicprng
Signeture of signing rupenisor; ;h-s %
trryGMil
Number of ldrpeq{fo-trq pcr ltem () i'Iotel,,'
r GoPti I.
Reddentlel, per unll, oeiltce lnduded:
1,000 eq. ft. orloss (4)$1t6.00 $
Each additiooal 500 sq. ft. or portion
thereof r[l6.00 $
Limited enerry (2)$44.00 $
Eech rognufacturcd homc or modular
dr*tlling tcrvicc or ftcdcr (2)$09.00 $
Serrrices or ftederc: lnstallation, alteration, ralocation
200 ampe or less (2)slI2.00 $
201 to 400 amps (2)$131,00 $
aOl to 600 anps (2)$221.00 $
601 to 1,0(X) asrps (2)$2Es,00 s
Owr 1,000 ampe orvolts (2)$654,00 $
Rcconnoct ooly (2)$89.00 $q1z
Teoporrry rervicec or lee-ders: tMallatiOn, altemtion, relocation
200 amps or loes (2)$09.00 $
201 to 400 aops (2)sr22"00 $
4ol to 600 ampo (2)$u7.00 $
Ove,r 600 aups or 1,000 volts, ses s€rvices or feeders recrion above
Errnch cktuit!: nett, aheration, exterrslon pet panel
a. Fcc fr,r branch oircuih with p,urchase of a sewice or foeder fte:
Each bmnch circuit $8.00 $
b. Fc* for bnnch cirqrito without purchase of a sewice or feeder foe:
$89.00Firsr bnrlEh chll$t (2)$
Eech edditional braoch circurt $$,00 $
MbcelliAnoout tb€02 sanice orfeedr not inctuded
Each pumg or imgEtisn circlc (2)$89.00 $
Each sigg or outline lightrng (2)s69.00 $
Sigual cirorit or a limircd-energy paael,
alafiEtion, or cxtcorim (2)$o9.oo $
(A) Enter subtotal ofabove fees
(Mlnlmum Pernit fer $102.(X))
Erch rrlditionel iwpectioo: (l)sl02.00 $
$
$@) Botor 12% surdnargc (.t2 r [A])
(C) TechnologyFee (5% of [A])$
TOTAL feer aod eurchuges (A through D):$
-.r' !, 1
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