HomeMy WebLinkAboutPermit Electrical 2009-7-22
Electrical Permit A
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225 Fif.h S'r....Spri.gfi.ld, OR 97477.PH(541)726-J7SJ.FAX(S41)726-J689
RE-50+N PErZ B,RicHA~SO/V
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. I Date";1 /7f?-/ 0 q I
This permit is issued under OAR 9IS-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days ofissuan~e or if work is suspended for ISO days.
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I Residential, per unit, service included: I
11.000 sq, ft. or less (4) $134.00 $ I
I ~~oaritional 500 sq. ft, or portion $ 25.00 $ I
I Limited energy (2) I $ 32.00 I $ , I
I Each manufactured home or moduhr I I " I
dwellins service or feeder (2)' $ 63.00 $
I Services or feeders: ins/aUation, ~/Ieration. relocation I
I 200 amps orless (2) I $ 81.00 I 5 )
20 I to 400 amps (2) I $ 95.00 I 5 ,.1
40 I to 600 amps (2) I 5158.00 I 5 ./
I 601 to 1,000 amps (2) I 5205.00 5 'I
lOver 1,000 amps or volts (2) I S469.oo 5 I
I Reconnect only (2) I $ 63.00 5 l.tf.:> I
I Temporary sen-ices or feeders: i~tallation. alie,alion, relocation r
1 200 amps or less (2) $ 63.00 5 I
201 to 400 amps (2) $87.00 5 1
401 to 600 amps (2) 5126.00 $ I
lOver 600 amps or 1,000 volts. see ~ervices or feeders seclion above I
I Braoch circuits: new, alteration, e..xlension per panel I
I a. Fee for branch circuits with pur~hase of 11 service or feeder fee: I
Each branch circuit I 5 6.00 I s I
b. Fee for branch circuits without purchase of a service or feeder fee: I
y. 1 Fax:t First branch circuit (2) : I I 5 55.00 I 5 '1
rOS(~ ,nfftlrtU>n l'n-l.( ,Enchadditionalbranchcircuit I S 6.00 5 I
I CCB license no.:/ I BCD licelle no.:QlD - tf~ 't I Miscellaneous f.es: smice or feeder no' included I
I Signing supervisor's license no: Lf 1 :::J. I 5 I Each pump or irrigation circle (2) 5 63.00 5 I
I Print name of signing superviso .S;~~Vfl _ vyr-f I EachSlgnorouthnehghtmg(2) 563.00 5 .1
'Signature of signing supcrvi"4:'" I Signal. CircUit or a h!TIlIed-energy panel, S 63.00 S
fU" , ~ aJreratJon, or exrenSJon (2)
, V I Each additional inspectinn: (I) S58.00 S
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(A) Enter subtotal of above fees I
(Minimum Perml. Fee 558.00) 5 1&>1,
I (8) Enter 12% surcharge (.12 x [All 5 '1, ':1.0 I
I (C) Technology Fee (5% of [All S ?,.\ ~
I TOTAL fees and surcharge, (A through C): 5 .\ ~:1l
r~lr0.C~LlfG,<:l,V;ERNMENTIf~p.P.RO.v.4\l:~~'
I Zoninja)'provaJ verified? 0 Yes [) No
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1 0 Residential 0 Government 0 Commercial I
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I Job site address: ~~~ 5 ~ 'J};/)
I City: a t'Q 'e}ui 1 State: O~ 1 ZIP: ~"'TI
I iluheHciQll: Lot no.CX'OCl:::>
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e'~'~.!lI~i' ~P.B0F1ER:r;v~O~~..1''':''~1
I Name: c.' ~~MO 'f-'b
I Address:\ ~ ~\.."t) ~ ~t'*\OO
I CityGD'D... v..\~ I State:~1 ZIP~%\"'lO I
, Phone: ) Fax: I
I E-mail: I
This installation is being made on residential or fann property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
I 479.540(1) and 479.560(1).
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