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~J lt/~l~RtOl~ COUNTY BUILDING INSPECTION <br /> Se.ator Sldg..o. 22S <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> <br />Owner: ........ Phone: Maiiing Address: <br />__T. gd Zacher 678-5993 12377 Donald Rd. N.E., A~urora, OR <br />Job Address: Site No,; Cro~'Street: <br />saiae <br />Electrical Firm; Phone; Address: <br />JR Electric 981-3913 P.O. Box 266, ~ubbard, OR 97032 <br /> Supervising Elect'~i~ian ,. ..... Phone; ...... Address: ..... <br /> Joseph V ,~_D.Tyden ...... same same <br /> Electrical Contractor's No.: Home Builder's RegistraiJ~n NO,: ......... <br /> 24-205C ...... 50829 <br /> Supervising I useof .......... Residential r~ New [] Addition L3 <br /> Building: <br /> Electri,~cian.~ NO,: 3138~8 ._,l _ Occupancy <br /> Commercial [] Alteration [] Relocation [] Change [] <br /> <br /> No, RESIDENTIAL <br /> ....... Residence wiring less than 1000 sg. ft ................................. @ $ 50,00 <br /> Residence wiring less than 2000 sq. ft, @ $ 75.00 <br /> -- Residencewiringover2000ed. ft ............ , ....................... ('cOS 105,00 <br /> __ Electric heat installation in existing residence ........................... @ $ 30,00 <br /> SERVICES <br /> __ Temporary Construction Service ..................................... @ $ 80.00 __ <br /> __ Service changeonlyin an existing residence ........................... ~> $ 30,00 <br /> Commercial or Industrial: <br /> __ Servlce not over 100amperes ....................................... @ $ 45.00 <br />__ Serviceover 100 amperes Put not more than 200 amperes ................. @ $ 70,00 __ <br />....... ServJceover~00amperesbutnotmorethana00amperes ................. @ $ 100,00 <br />__ Servioeover400ampereebutnotmorethan600amperes ................. @$ 150.00 <br />__ Serviceover600amperes ......................................... @ $ 200.00 <br />__ Serelceover600volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />Installation of Alterations or Relocation of Distribution Feeders: <br />Not more than 100 amperes ........................................ @ $ 25,00 <br />__ Over 100 amperes but not more than 200 amperes ....................... @ $ 40,00 <br />...... Over 200 amperes but not more than 400 amperes ....................... ~$ 70.00 <br />__ Over400amperes ............................................... @ $ 85,00 <br />..__ Feederover600volts ............................................. ~)$ 120.00 <br /> MISCELLANEOUS <br />...... A. Each trailer or mobile home space (Service equipment) .................. ~ $ 25.00 <br />__ B. EaCh Supply for mobile home (Contraction) ........................... ~/) $ 25,00 <br /> ~. C, Eachirrigationpsmp(Attacharnapshowinglocation) ..................... ~$ 30,00 <br />__. D, Each electric sign or outlinelighting ................................ ~ $ 30,00 <br />....... E. Each swimming pool bonding) ................................... (~i, $ 30.00 <br /> BRANCH CIRCUITS <br />__ One new circult;alteration or extension ............................... (& $ 20,00 <br />...... Two or more new circuits; alterations or extensions ....................... ~ $ 80.00 <br />__ Other (as per NEC and Building Official) ......................................... <br />__ On-Site T~chnical Review (apply directly at Marion County only) ...................... <br />__ Industrlal Plant Inspection (apply directly ar Marion County only) ...................... <br />__ Reinspectlon 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 />1 , 50 <br /> <br />7.68 I <br /> ..... I <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 />SIGNATURE OF APPLICANT:.__ <br /> <br />MC 15.34 (Owner doing his own work) <br />Rev, 12/88 <br /> <br /> <br />