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I. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED wrrHIN 180 DAYS OF L~SUANCE <br />OR IF WORK IS SUSPI~'DED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B; FOR OWNER INSTALLATIONS <br /> <br />Property Owner <br /> <br />Mailing Address I Phone <br /> <br />City/State/Zip <br /> <br />The installation is being made on pro. ny I own which is not intended for sale, <br />l~se, or re. nL <br /> <br />Owner's Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br /> Number of Inspections per permit allowed-'n <br /> <br /> Re~idelitlal <br />A. <br /> Per <br /> Unit <br /> Service Included: Items Cost (each) S <br /> <br />1000 sq. fl. or less '~ $85.00 4 <br />Each additional 500 sq. ft. <br />or punish thereof $~ 5.00 <br /> <br />Each Manufd Home or Modular <br /> <br />Dwellin~ Service or Feeder <br /> <br />$40.00 <br /> <br />Services or Feeders (Does not inlcude branch circuits, see section D) <br />Installation~ Alterations or Relocation <br /> 200 amps or less $50.00 <br /> 201 amps to 400 amps $60.00 <br /> 401 amps to 600 amps $100.00 <br /> 601 amps to 1000 amps $130.00 <br /> O~r 1000 amps or volu $300.00 <br /> R~connect only $40.00 <br /> <br />C. Temporsry Services/Feeders <br />Installation, Alteration, or Rdecation <br />200 amps or less $35.00 <br />201 amps to 400 amps $40.00 <br />401 amps to 600 amps $80.00 <br />Over 600 amps or 1000 volts <br />see "B" above <br /> <br />D. Branch Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) The fee for branch circuits with <br /> vurchase of service or feeder fee <br /> <br /> Each branch circuit $~.00 <br /> b) The fe~ for branch circuts without <br /> purchase of service or feeder fee <br /> <br /> Fu~t branch circuit $35.00 <br /> Each additional branch circuit $~.00 <br /> <br />E. Miscellaneous (Service or Feeder Not Included} <br /> Each pump or irrigafioo circle $40.00 <br /> Each sign or ontliae lighting $40.00 <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension $40.00 <br /> <br />F. Each additional Inspection <br /> over the allowable in any of the <br /> above, per Inspection $35.00 <br /> <br />G. Minor Installation Labels <br /> Pack of 10 labels @ $5.00 each $50.00 <br /> (sold only to electrical contractors) <br /> <br />H. Other <br /> (As required by Building Official) <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. <br /> A2. Add 5% sm'charge (.05 x A 1) <br /> <br /> Subtotal <br /> <br /> B. Enter 25% of line A1 for Plan Review <br /> (See. 3), if required <br /> C. Invosfigation Fee (ff l~.quired) <br /> D.. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Reeeip~ No. <br /> <br /> <br />