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FOR CITY USE ONLY <br />Received By:_ Dat~: <br />Zoning By: City: <br />Receip~ #: Amount: <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> Please ~ompl~e a. E Section~, 1 ~rough $ <br /> <br />I. LOCATION OF IN~rAI~LATION <br /> <br /> Phone: <br /> <br /> PERMITS ~ NON'TRAN$1rF-'~4I~LE *41gD <br /> 1S NOT STARTED WITFIIIg 180 D~IY~ OFIXS~IANCE OR IF <br /> <br />Parkin Electric, Inc. 20250 8 MoraVia A~e. <br />Orego~ Ci~, OR 97045 503-657-4958 fax: 557-1059 <br /> Contractors License ~: 34-~ exp. 1~01-99 <br /> Supe~isor: 4241,S exp. 10-01-01 <br /> Con~tors Board Ret ~: 35~5~ exp. 10-12-00 <br /> Me~o ~ 2416 exp 11-01-98 <br /> O~er: <br /> <br />]C~ctom ~M No: <br /> <br /> Si~mre of Su~sMg EI~: <br /> 2B, FOR O~gR ~0~ ' <br /> <br /> ~ ~r: ~lease prin0 <br /> <br /> ~il~ ~r~: <br /> <br /> Ci~: Sm~: Zip: <br /> <br /> I am the PROPER~ O~R and own. re~ide in. or will re~lde in the <br /> <br /> s~ucmre ~$ sold or offered for <br /> <br /> I Co~uction Con~a~or: ~rd. lfl c~ng~ my mind and do h~e a <br /> Con~actors Board, I will Jmmedtarely not~ Marion Coun~ of tht <br /> <br /> 3., P~ RENEW SE~[ON <br /> <br /> ] M~ CounW ~ n~ ~u~ a pl~ ~i~. W~ ~ll p~o I <br /> plan mvi~ ~i~ if you ~pl~ S~ion 5B and ~bmit ~ (2) <br /> <br /> ONCO ,.UILD.,C",SPE iON??-- <br /> <br /> 3150 Lan3150 Lancaster Dr. NE - Suk¢ C <br /> Selcm, Oregon 97305 <br />24 ~. Inspection Line 373-4427 FAX 588-7948 <br /> <br />~allg/F.4~HE DULE (complete and eater total ia Al) <br /> <br /> Number o£Insp~io'a~ I~ !t~mit allowod-- <br /> Residential Per Unit, Service Included <br /> <br />1000 St. Ft, or less <br />Each Additiotm1500 Sq. FL or potion thereof <br />Limltsd Energy <br />Ea Manuth~,ur~d Hom~ or <br /> Modular Dwell/ag Scrvi~ or Feeder <br /> <br />It~'m Cost (each) Sum <br /> x $110.00 =$ 4 <br /> x $ 20.00 = $ <br /> x 230,00 ~=$ I <br /> <br />x $52.00 =$, 2 <br /> <br />IL Services or Feedcrf (Does not Include branch Circuit, See Section D) <br /> loMaEa~n, Alteration, or <br />200 amln or tess / x 2 65.00 - 2 <br />201 amps to 400 amps x SSO.00 = $ 2 <br />401 amps to 600 amps x 2130.00 = $ 2 <br />60t err~s to 1000 amp~ x $170.00 = $ 2 <br />Or= 1000 amps or vnlts x 2390.00= $ 2 <br />Reconnect Only x $ 55.00=- $ 2 <br />C. Tem~L)Or_a rvry~ede r~ ' <br />Inltalla~on, Alteratioah or Relocation <br />200ampsor ~ x $45.00 = $ 2 <br />201 amps to 400 amps n $ 55.00 = $ 2 <br />401 ampsto600 amps x $110.00~ $ 2 <br />Ov~ 600 amps ~ 1000 voI~ see "B" above <br />D. Breach CireoRs <br />New, Alteration, or E~t~naloa Per Panel <br />a) tho fne for branch circuits with the ourchase <br /> ofSe~vicem'Fe. MerFee. EaBrCir ~ X $ 3.00 = $.. <br /> b) The f~e for branch circuits without the <br /> vurchase of Service or Feedo' Fee: <br /> First Branch Ckcuit <br /> Each Additional Braz~ch Circuit <br /> Mlacellaaeone (Service or Feeder Not Ioeluded <br /> ch pump or in{ration circle <br /> ch Sign Or Ou~l~¢ Lighfmg <br /> ~gnal Circuit(s) or a Lingtsd Energy Panel, <br /> Alteration, or Extension <br />F. Each Additional Inspection, over the atiowable <br /> <br /> Pack of 10 labels (~ $10.00 each <br /> (Sold only to Electrical Coaaactors) <br /> <br />x $ $0.00 = $ <br />x $ 3.00=$ <br /> <br /> $ ~$.00 = S 2 <br /> $55.00 = $ 2 <br /> <br />x $55.00= $ <br />x $50.60= $ <br />x Sl00.00~ $ <br /> <br />x $62.50/hr- $ <br />x $ .09 = S <br /> <br />TOTAL $ <br /> <br />5. FEES <br />Al. Enter To~ Fees from Section #4 <br />A2 Add S~at~ Surcharg~ (.05% x Al) <br /> <br />SUBTOTAL: S 7/. ~ <br /> <br />B. Enter 30%oflinoA1 forPlaaRoview <br />C. Investigation Fee, if required <br />D. Re~nspe~on Fee ($50.00) <br />E. Addition~l Plum Review (62.50/b,r. <br /> minimum one-half hour) <br />F. Inspection for which no fee is specifically indicated, <br /> ($62.50/hr, minimum one hour) <br />G. Inspection Ou~sick: Normal Business Hours, <br /> $62.50/~, minimum ~wo bourn) <br />H. Indus~xial Plant ($62.50/hour) <br /> <br />MC 15-34 Rev 9/98 <br /> <br /> <br />