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FISR~OFFICE USE ONLY ! MARION COUNTY BUILDING INSPECTION <br />Received by:. ~7~01 <br />Date: <br /> ~*~;xle-A-~onc,"'5~l~904 ~ /~O~r'~ ~. Permit No. <br /> ELECTRICAL PERMITAPPLICATION I <br /> P/ease complete alt Sections, I through 5 ~.. ~8/0~, /~ '~?ued by' <br /> <br /> 1. ~AYION OF INSTAL~TION ~/~ SCHEDULE (~mpletu ~d enter u/al ~ ,[ l ~low) <br /> <br />JobAddress 14452 ARNDT ROAD <br />city AURORA I Cross st. <br />Directions COLUMBIA HELICOPTER <br /> <br />TREATMENT PLANT <br /> <br />PE~S ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENVDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />ElectricalContractor FRAHLER ELECTRIC IPhone 639-4627 <br />Mai/ingAddmss 11860 SW GREENBURG RD., TIGARD, OR <br />Property Owner IPh°ne 639-4627 <br />Contractor's License No. 34-13C <br /> <br />Con/fac/oCs Board Reg. No. 374-10 [ Job No. 56325 <br />Signature of Supervising Electric/an ~~ <br />Supe~sof s License No. 18165 IPh°ne xq°' 639-4627 <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner <br /> <br />Mailing Address <br /> <br />City/State/Zip <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 <br /> <br />A. <br /> Residential <br /> Per <br /> Unit <br /> 1 <br /> Service Included: Items Cost (each) Sunni <br /> 1000 sq. ft. or less $85.00 4 <br /> Each additional 5013 sq. ft. <br /> or potion thereof $15.00 <br /> Limited Energy $20.00 -- 1 <br /> <br />Each Manufd Home or Modular <br />Dwelling Se~ice or Feeder $40.00 <br /> <br />B. Services or Feeders (Does not mlcude branch ci rcuits, see section D) <br /> <br />Installation, Alterations o~ Relocation 1 <br />200 amps or less <br /> <br /> (As required by Building Official) <br /> <br /> I5o.00 5 0...9 ~ <br /> 60.00 -- 2 <br />$100.00 2 <br />$130.00 2 <br />$300.00 2 <br />$40.O0 2 <br /> <br />$35.00 --2 <br />$40.00 2 <br />$80.00 2 <br /> <br />$2.00 lO.O0 <br /> <br />$3,5.00 <br /> $2.00 <br /> <br />$40,00 <br />$40.00 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />5. FEES <br /> Al, Enter total of fees from Sec. #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br /> Subtotal <br /> <br /> B. Enter 25% of line A 1 for Plan Review <br /> (Sec. 3), if required <br /> C. Investigation Fee (if requi~ed) <br /> D. Reinspecfion Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />$ 60. O0 <br />$ .~.uu <br /> <br />$ <br />$ <br />$ <br /> <br />$ 63.00 <br /> <br />MC 15-3411/91 Receipt No. <br /> <br /> <br />