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PERi',/rI~ ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT ~TARTED wrI'HIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSP..~NDI~D FOR 180 DAY~. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Eleadcal Contractor <br /> <br />Mailing Address <br /> <br />No. <br /> <br />ContracWr's Board Reg. No. I lob No. <br />Signature of Supev, h.fing Electrician <br />Supe~4so~'s License No. I Phone No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />~ ~s~ ~ ~g ~m ~ p~ I ~n w~ is ~ ~d~ for ~, <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 />rextuirod submission of lighting power calcuhfions, phns, <br />and specifications when required by the Oregon Structural <br />Speci~y Code, Chapter 53. <br /> <br />MC 15-34 8/94 <br /> <br /> 4. FEE SCHEDULE (Complete ~d emer totalin Al below) <br /> <br /> Number of Inspections per permit allowed <br /> <br /> A. <br /> Reeldentinl <br /> PeF <br /> Unit <br /> Service Included: Ite~ns Cost (each) bum <br /> <br /> 1000 sq. fl. orless $95.00 <br /> Each addition~. 500 scl, <br /> or poni~ t~ereof $15.00 <br /> Limited Energy $20.00 <br /> Each Manufd Home or Moduhr <br /> Dwdling Se~vke or Feeder <br />~ Servtc~z or Feeders (Does not inlcude branch drcuits, see section D) <br /> l~ls~allaUo~, <br /> ~-200 amps or less $50.00 O~0 <br /> 201 ~ to 400 amps $80.00 <br /> 401 ~mps to 600 amps $100.00 <br /> 601 amp* to <br /> Over 1000 ~nps or volts $300.00 <br /> Reconnect only $40.00 <br /> <br /> C. Tm.porsry SerHce~Feeders <br /> Installation, Alteration, or Relmmtion <br /> 200 amps or less <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps <br /> Over 600 amps or 1000 volts <br /> <br /> D. Branch Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) Thc fee for branch c~c~ts with <br /> m~chase e~ se~vi~e or feeder fee <br /> <br /> Each branch circuit <br /> <br /> b) Thc fee for branch drcuts wlthout <br /> ~rchase of se~ce or feeder fee <br /> <br /> ~ branch circuk <br /> Each ad~fienal bn~ch c/rc~ <br /> <br />, F~ M~scellaneons (Service or Feeder Not <br /> "-- Each ~ or ~gafion c~mle <br /> Each n~ or corinne <br /> Sisal circuit(s) or a limhe~ <br /> panel, alteration or exmasion <br /> <br /> F. F~ch ~ddRIonal Inspection <br /> over thc allowabl~ in any of thc <br /> <br /> G. Minor Installation Labels <br /> Pack of 10 labels @ $5.00 ~ach <br /> (soid only to dectrica[ contractors) <br /> <br /> H. Other <br /> ( As required by Budding Offic;.,l) <br /> <br />$35.00 ,, 2 <br />$40.00 2 <br />$80.00 2 <br /> <br />$2.00 <br /> <br />$35.00 <br />$~.00 <br />$4o.oo ~/.-/0 ~ <br />$40.00 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />~ FEES <br /> Al. Enter tyrol of fees from Se.c. #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br /> Subto~i <br /> <br /> B. Emir 25% of lineAl for Phn Review <br /> (Sec. 3),if required <br /> C, Investigation Fee (if requital) <br /> D. Reinspecfic~ Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />R~eeilx No, <br /> <br /> <br />