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' E~e Idg. No, ~25 <br /> <br />Date, Sal~_.~_j~?regon 97301 <br /> <br /> Co,e-A-Phone 4=30 RM..- 8:00 A.M. <br /> <br /> EU~LD~i~L~q~ PERMIT APPLICATION <br /> <br />Supervising Eiectriciam <br /> <br />Phone; <br />Site No.: <br />Phone: <br />Phone: Address: <br /> <br />~,ddress: <br /> <br /> Electrical Contractor's No.: Home Bui~er's Regi3tration No.: <br /> <br />'-~'~i~in~ .......... l "tJ'~e' (~(-' ' /Residential { ~ <br /> / ~ 'd~ 4 Building: ,,.X__//e, Commercial~J New <br /> EtectricJan~ No.: <br /> Alteration ~ <br /> <br />Addition [] <br />Relocation [] <br /> <br />Occupancy <br />Change [] <br /> <br /> NO. RESIDENTIAL <br />..... Residence wiring less than 1000 sq, ft ................................. @ $ <br />__ Restdenoe wiring less than 2000 sq. ft ................................. @ $ <br />__ Residence wiring over 2000 sq. ft .................................... @ $ <br />__ Electd¢ heat installation in existing residence ........................... @ $ <br /> SERVICES <br />~'.. ,, Temporary Construction Service ..................................... @ $ <br />__ Service change only in an existing residence ........................... @ $ $0,00 <br /> Commercial or Industrial: <br />__ Service not over 100 amperes ....................................... (-c~ $ 30,00 <br />.___ Service over 100 amperes but not more than 200 amperes ................. @ $ 50,00 <br />__ Serviceover2OOamperesbutnotmorethan4OOamperes ................. @$ 70.00 <br />__ Serviceover4OOamperesbutnotmorethanCOOamperes ................. @$ 100,00 <br />__ Service over 6OO amperes ......................................... @$ 130.00 <br />____ Serviceover6OOvolts ............................................. @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders; <br />__ Not morethan 100amperes ........................................ @ $ 20.00 <br />__ Over 100 amperes but not more than 200 amperes ....................... @ $ 80,00 <br />........... Over 200 amperes but not more than 400 amperes ....................... @ $ $0.g0 <br />__ Over400amperes ............................................... (~[/$ 60,00 <br />__ Feeder over 800 volts ............................................. ¢~ $ 80.00 <br /> MISCELLANEOUS <br />__ A. Each trailer or mobile home space (Service equipment) .................. (4~ $ 20,00 <br />__ B. Each sepply for mobile home (Connection) ........................... ~.~ $ 20.00 <br />__ 0. EeshirrigatiOnpump(Attachamapshowinglocation) ..................... ((7!$ 20.00 <br />__ ID, Each electric sign or outline llghting ................................ @ $ 20.00 <br />__ E, Each residentlalswlmmlng pool .................................. @ $ 20,00 <br /> BRANCH CIRCUITS <br />____ Onenewoi~Cuit;alterationore×tension ............................... (-c[~$ 15,00 <br />...... Two or more new oimuits; alteretlone or extensions ....................... @ $ 20,00 <br />__ Other (as per NEC and Building Official) ......................................... <br />__ On-Site Technical Review (apply directly at Marion County only) ...................... <br />__ icdustdal Plant Inspection (apply directly at Marion County only) ...................... <br />__ Reinspectloneae ................................................ ~$ 15,00 <br /> FEE <br /> STATE SURCHARGE <br /> <br />30,00 <br />50,00 <br />70.00 <br />20.00 <br /> <br />20.00 ~. o~ <br /> <br /> Please return COMPLETE APPLICATION ~ ...._ ~~ <br /> with the indicated fee. <br /> FLEET SURCHARGE ~ O ~ <br /> <br />L.J HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to make an electrical installation for <br /> my own use and this property is not being corjstructed for sale, lease or rent. <br /> <br /> <br />