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% R.o. <br />Received 19~Jl~ ~ , ~ Sen~or Bldg. No. 225 <br /> <br />Date; ~ ~ ~,~ ' ' ' ~ Salem, O~on 973~ <br /> ~ ~X C~A-Phone 4:30 RM. - 8,00 A.U. <br /> ~ ~ ~ Phone 588~147 <br /> <br /> ELE~RICAL PERMIT APPLICATION <br /> <br />Owner; Phone: Mailing Address: <br />City of Donald 678-5543 P.O. Box 388, Donald, OR 97020 <br />Job Address; Site'i'4o.: Cross Street: <br />2--O_813 Butteville Rd. N.E., Dona~d.~.....O..R Ramirez mobile home park <br />Electrical Firm: Phone: Address~ <br />JR Electric 981-3913 P.O. Box 266, ~ubbard, OR 97032 <br />Supervising Electrician: ............ Phone; Address; <br />Joseph....V.. Dryden same same <br />Electrical Contractor's No,: ............ Home Builder's Registration NO.: <br />24-205C 50829 <br />Supervising ['=0~ of Resideetial [] New [] Addition ~ O'--ecu pancy <br />Electrician's N°':_?1388/ Building; Commercial [] Alteration [] Relocation [] Change [] <br /> <br /> No. RESIDENTIAL <br />__ Residence wiring less than 1000 sq, ft ................................. ('97 $ 50,00 <br />....... Residence wiring less than 2000 sq. ft ................................. @ $ 75,00 <br />__ Residence wiring ever 2000 sq, ft .................................... @ $ 105.00 <br />..... Electric heat Installation in existing residence ........................... ~ $ $0,00 <br /> SERVICES <br />__ Temporary Construction Service ..................................... ~ $ 30.00 <br />___ Service change onlyin an existing residence ........................... @ $ 30,00 __ <br /> Commer~ial or Industrial: <br />...... Service not ever 100 amperes ....................................... @ $ 45,00 <br />__ Service over 100 amperes but not more than 200 amperes ................. (&~ $ 70,00 <br />-- Serviceover200amperesbutnotmoretbso400amperes ................. @ $ 100.00 <br />____ Service ever 400 amperes but not more than 800 amperes ................. @ $ 150.00 <br />__ Service over 600 amperes ......................................... ~{~ $ 200.00 <br />.... Service over 600volts ............................................. @ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders; <br />__ Not morethan 100amperes ........................................ @ $ 25,00 <br />__ Over 100 amperes but not more than 200 amperes ....................... ~_~ $ 40.00 <br />---- Over20Oamperesbutnotmorethan400amperes ....................... ~i/$ 70,00 <br />__ Overa00emperes ............................................... @%$ 85.00 <br />__ Feederover600volts ............................................. @ $ 120,00 <br /> MISCELLANEOUS <br />__ A. Eachtrailerormobilehomespace(Servlceequll~mem) .................. ¢.i/$ 28.00 <br />__ B, Each supply for mobile home (Connection) ........................... ~-~> $ 25,00 <br />__ C, Eachirdgationpsmp(Attacharnapssowin9location) ..................... @$ 30,00 <br />__ D, Each electric sign oroutlinelighting ................................ (? $ 30,00 <br />__ E. Each swimming pool (bonding) ................................... (~ $ 30.00 <br /> BRANCH CIRCUITS <br />_1_.,,.., Onenewcircult;afterationorextension ............................... ¢?$ 20.00 <br />__ Two or more newcircuits; alterations or extensions ....................... (~ $ 30,00 __ <br />-- Other (as per NEC and Building Official) ......................................... <br />__ On-Site Technical Review (apply directly at Marlon County only) ...................... <br />__ Industrial Plant Inspectlon (apply directly at Marian County only) ...................... <br />__ Relnspection Fee ................................................ @ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br />with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE <br /> TOTAL <br /> <br />20.00 <br /> <br />SIGNATUREOFA"~I. ICANT; 'T~'¢~ W' ~ .~k~"' Job NO: <br /> <br />[] 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 constructed for sale, lease or rent. <br /> <br />81GNATIJR~ OF APPLICANT: <br /> <br />Rev. 12/88 <br /> <br /> <br />