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1. LOCATION OFINSTALLATION <br /> <br />2A. CONTRACTOR XN~TALLATION ONLY <br /> <br />8 TE~,AR ON C;OUNTYpe itNo <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (C43~ple~e md e~tr, r total in A1 below) <br /> <br /> A. l~sfdentlal Per Unit <br /> ' SorT~cell~: I~ Co~ Sum <br /> <br /> 1000 ~q. ft. or ~IS $85.00 4 <br /> <br /> ~ $15.00 <br /> l~.b ~n~ or M~r $20.00 1 <br /> l~,~m..~ ,S~vi~ or Feed~ $40,00 2 <br /> <br />B, Serdcor or* Fee~Lers (1~ no~ inlc~d~ b~nch c~Fc~u, se~ se.~o~ D) <br /> ]nstdhtlon, Altoratlons or RdocaUon <br /> <br /> ~01 ~al~ ~o 400 ~mln $60.00 __ ~ <br /> 401 ~mp~ ~o 6~0 &raps $100.~ ~ 2 <br /> <br /> ~0.~ 2 <br /> ~ orv~ $130.~ <br /> ~.00 ~ 2 <br /> <br /> h~ ~on, ~ Rd~ffon <br /> )s~hs $~.00 ~ 2 <br /> ~ $~.00 2 <br /> $~.00 2 <br /> <br />Board R~S~ No. ~ob No. <br /> <br />Supra, bols ].ica~s~ No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Owner <br /> <br />Th~b~.dh~ is ba~n~nM.~.~pml~fl7 1 own whL~3 i~ mi bIMnd~ for ul~ <br /> <br />3. PLAN REVIEW SECTION <br /> <br />Wo will provid~ plan mvi~w ~ ff you compl~t~ Section <br />SB and submit two (2) se, L~ of plans and specification~ with <br />~ application. <br /> <br />This optional plan mvi~w program does not suspead ~ho <br />required submission of lighting pow~ calculaQons, pla~s, <br />and ~ecific~on~ when rcquir~ by tho Oregon S h-uc~mfl <br />Sp~.,ialt7 Co~, C~ap~r 53. <br /> <br />D. Branch Clrcult~ <br /> N~w, Ai~ratioa, or Extension Per Panel <br /> <br /> a) ~J~ f~ f~ Ixinch cL-cuiu w~th <br /> ~ branch clx~ult ~ $2.00 <br /> b) The fee for branch circuu without <br /> <br /> First txaneh clrcuit $35.00 <br /> Each additional bnnch clrcuit $2.00 <br /> <br />~ Miscellaneous (~ervice or Feeder Not Included) <br />Each ixuap ~ inigatim circ~ $40.00 <br />Each ~ or canine .u~in.' ~ $~o.oo <br />Signal circuits) o~ a llmit~l m~xy <br />panel, altm~J, ca or extension $40.00 <br /> <br />G. Minor Inst~l~tloa Labe~ <br /> P~ck c~ 10 ~ ~ ~.00 e~ch $50.00 <br /> <br />IL Ol~r <br /> (At r~q~r~ b~ B.,~!~_;_.~ <br /> <br />5. FEES <br /> Al. Emer ~c~l of f~ from Sec #4 <br /> A2. Add 5% ~urch~uga (.05 x Al) <br /> <br /> ~Jbtotal $ <br /> <br /> B. Enter 25% of line Al for Plan I~view <br /> (Sac. 3),it' req~'ed $ <br /> <br /> D. ]~im F~ ($25.00) $ <br /> TOTAL AMOUNT DUE <br /> <br />MC 15-34 8/94 Re~ip~No. <br /> <br /> <br />