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CLACKAMAS COUNTY <br /> ~DEPARTMENT OF TRANSPORTATION <br /> AND DEVELOPMENT <br />BUILDING SERVICES DIVISION <br />902 ABERNETHY ROAD, OREGON CITY, OREGON 97045 <br />PHONE 655-8521 · FAX 650-3019 <br /> INSPECTION REQUESTS: 655-8699 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> PERMIT # <br /> <br />DATE <br /> <br />ISSUED BY. <br /> <br />PLEASE COMPLETE ALL SECTIONS I THROUGH 5. <br /> <br />1. LOCATION OF INS~,~TION -- -~-- <br />Directions _ <br /> <br />PERMITS ARE NON-TRANSFERABLE AND <br /> <br /> NON- <br />REFUNDABLE AND EXPIRE iF WORK IS NOT STARTED <br />WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS <br />SUSPENDED FOR 180 DAYS. <br /> <br />2. B. FOR OWNER INSTALLATIONS: <br /> <br />Address <br /> <br /> Cib/ State Zip <br /> <br />AS per ORS 479.540, I certify that this structure is not <br />intended for rent, sale, lease or exchange. <br /> <br />Signature <br /> <br />3. PLAN REVIEW SECTION <br />Please check appropriate item and enter fee in Section 5B. <br /> __ I & 2 Family dwellings over 320 amps s/c meter <br /> __ 4 or more residential units in one structure <br /> __ Service over 225 amps; feeder 400 amps or more <br /> __ System over 600 volts nominal <br /> __ Building over 3 stories in height <br /> __ Building over 10,000 sq. ft. <br /> __ Occupant load over 99 persons <br /> __ Manufactured Structures Park or Recreational <br /> Vehicle Park; new, addition or alteration <br /> -- Classified area or structure containing special <br /> occupancy as described in NEC. Chapter 5 <br />Submit 2 sets of plans with application where any of the <br />above apply. Not required for temporary const, services. <br /> <br />COMPLETE FEE SCHEDULE BELOW <br /> Number of Inspections Per Permit Allowed <br /> <br /> A. New Residential-Single or <br /> Multi-Family per dwelling unit. <br /> Service Included: Items Cost (Ea.) Sum ~' <br /> 1000 sq. ft, or less __ $120 4 <br /> Each additional 500 sq. ft. <br /> or portion thereof $ 24 <br /> Limited Energy $ 48 __ 2 <br /> Each Msnuf'd. Home <br /> or Modular Dwelling <br /> Service or Feeder $ 48 2 <br /> B. Service or Feeders <br /> Installation, Alterations or Relocation <br /> 200 amps or less $ 72 ....... 2 <br /> 201 amps to 400 amps $ 95 2 <br /> 401 amps to 600 amps $143 2 <br /> 601 amps to 1000 amps $215 2 <br /> Over 1000 amps or volts $394 2 <br /> Reconnect only $ 48 1 <br /> C. Temporary Services or Feeders <br /> Installations, Alterations or Relocation <br /> 200 amps or less __ $ 42 2 <br /> 201 amps to 400 amps __. $ 89 2 <br /> 401 amps to 600 amps $120 2 <br /> Over 600 amps or 1000 volts see "B" above <br /> D. Branch Circuits <br /> New~ Alteration or Extension Per Panel <br /> a With Purchase of <br /> Service or Feeder, each $ 5 2 <br /> b. Without Purchase of <br /> Service or Feeder <br /> (i) First Circuit __ $ 40 2 <br /> (ii) Each additional <br /> Circuit __ $ 5 2 <br />E. Miscellaneous (Service or Feeder Not Included) <br />Each pump or <br /> irrigation circle __ $ 48 2 <br /> Each sign or <br /> outline lighting __ $ 48 2 <br /> Signal circuit(s) or a limited <br /> energy panel, alteration ~ <br /> or extension //~ _ $ 48 2 <br />F. Each additional Inspection <br />over the allowable in any of the <br />above, per Inspection <br /> <br /> $ 42 <br />Hours <br /> $60/hr. <br /> <br />G. Special Inspections <br /> <br />5. FEES <br />A Enter total of above fees $ <br />5% Surcharge (.05 X Subtotal) $ <br />SUBTOTAL $ <br />B. Enter 25% of line A for Plan <br />Review if required (Section 3) $ <br /> <br />TOTAL DUE $ <br /> <br />CCP-PW117 fRev 11/941 <br /> <br /> <br />