HomeMy WebLinkAboutPermit Electrical 2010-4-21
Electrical Permit Application
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225 Fifth Sll'eet.Sprlngl1clrl. OR 97477. Pli(541)726.3753+ FAX(541)726-36119
DEPARTMENT USE ONLY
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Permit no.:
Date:
This permit is issued under OAR 918-309-0000. Permits arc nontransferable. Permits expire ifworI( is not shu:ted within 180
days of issuance or if worl, is suspended for 180 days.
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LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes 0 No
CATEGORY OF CONSTRUCTION
1KI Residential 0 Government 0 Commercial
JOB SITE INFORMATION AND LOCATION
Lane
ZIP: 97477
Subdivision:
DESCRIPTION OF WORK
Re lace vandalized wirin
E-mail:
This inst<ll1ation is being made on residential or farm property
owned by me or a member afmy immediate family. This
properly is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
CONTRACTOR INSTALLATION
Business name: Olsson Industrial Electric
Address: 1919 Laura Street
E.mail:
CCB license no.: 20 - 2 41 C oeD license no.: 63473
Signing supervisor's license no.: 3334 S
Print name of signing supervisor:
S:.gnature of signing supervisor:
440.2584.} (9/08/COM)
FEE SCHEDULE
Number of Inspections pel' item () Qty.
Cost Total
ca, cost
$134.00 $\~- dJ
.
$ 25.00 $ :\t .cP
$ 32.00 $
$ 63.00 $
Residential, per IIllit, service included:
1,000 sq. ft. or less (4) \
Each additional 500 sq. f1. or portion n
thereof "lA
Limited energy (2)
Ench Illanufnctured home or moduJar
dwelling service or feeder (2)
Services or feeders: ill.i!{//!{//iol1, al/emlioll. reloca/ion
200 amps or Jess (2)
20\ to 400 amps (2)
401 to 600 amps (2)
60 I to ] ,000 amps (2)
Over J ,000 amps or volts (2)
Reconnect only (2)
$ 61.00 $
$ 95.00 $
$156.00 $
$205.00 $
$469.00 $
$ 63.00 $
Temporary services or feeders: {mlotla/ioll. al/ern/ioll. relocalioll
200 amps or less (2)
20\ to 400 amps (2)
40 I to 600 amps (2)
$ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Brllllch circuits: lieI\'. al/em/ioll, ex/ellsicm pel' pallel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional branch circuit
I $ 5500 I $
I $ 6.00 I $
..
Miscellaneolls fees: sell'ice orfeede/' !IO/ included
Each pump or inigalion circle (2)
Each sign or oulline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each lldditlonalinspcction: (I)
APPLICANT USE
$ 63.00 $
$ 63.00 $
$ 63.00 $
$58.00 $
(A) Enter subtotal of above fees
(Minimum Permit Fce $58.00)
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(8) Enter 12% surcharge (.12 x [AD
(C) Technology Fce (5% offAl)
TOTAL fees and surchllrges (A through C):
$
$