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    Restricted Energy

    Uploaded by

    Hari Ram Jamalpuria
    This document is a permit application for restricted energy electrical work for one- and two-family dwellings in Clatsop County, Oregon. It provides information on permit fees, inspections, contractor and property owner details, and payment methods. The applicant is applying for a permit to perform electrical work on systems like HVAC, security, irrigation and more. The form collects contact information, describes the work, and outlines the total fee calculation which includes permit fees, surcharges and reviews if needed.

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    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Restricted Energy

    Uploaded by

    Hari Ram Jamalpuria
    29 views1 page
    This document is a permit application for restricted energy electrical work for one- and two-family dwellings in Clatsop County, Oregon. It provides information on permit fees, inspections, contractor and property owner details, and payment methods. The applicant is applying for a permit to perform electrical work on systems like HVAC, security, irrigation and more. The form collects contact information, describes the work, and outlines the total fee calculation which includes permit fees, surcharges and reviews if needed.

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    © Attribution Non-Commercial (BY-NC)

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    This document is a permit application for restricted energy electrical work for one- and two-family dwellings in Clatsop County, Oregon. It provides information on permit fees, inspections, contractor and property owner details, and payment methods. The applicant is applying for a permit to perform electrical work on systems like HVAC, security, irrigation and more. The form collects contact information, describes the work, and outlines the total fee calculation which includes permit fees, surcharges and reviews if needed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    29 views1 page

    Restricted Energy

    Uploaded by

    Hari Ram Jamalpuria
    This document is a permit application for restricted energy electrical work for one- and two-family dwellings in Clatsop County, Oregon. It provides information on permit fees, inspections, contractor and property owner details, and payment methods. The applicant is applying for a permit to perform electrical work on systems like HVAC, security, irrigation and more. The form collects contact information, describes the work, and outlines the total fee calculation which includes permit fees, surcharges and reviews if needed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
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    DEPARTMENT USE ONLY

    One & Two-Family Dwelling Permit no.:      


    Restricted Energy Electrical Label #:      
    Application Office:      
    Transportation & Development By:       Date:      
    Building Codes LOCAL GOVERNMENT APPROVAL
    800 Exchange St Ste 100 Astoria, OR 97103 Zoning approval verified? Yes No
    Ph: (503) 338-3697, Fax: (503) 338-3666
    Web: co.clatsop.or.us
    This permit is issued under OAR 918-309-0400. Permits are nontransferable. Permits expire if work is not started within 180
    days of issuance or if work is suspended for 180 days.
    JOB SITE INFORMATION AND LOCATION If paying by credit card, please provide mailing address where
    you receive your credit card statement:
    PROPERTY OWNER:       ADDRESS:      
    Job site address:       FEE SCHEDULE
    City/State/ZIP:       Fee for all systems (includes two inspections): ..........................$31
    Project name:       Check type of work involved:
    Directions to job site:       Audio and stereo systems
          Data telecommunications
    DESCRIPTION OF WORK Doorbell
          Garage-door opener
    Heating, ventilation, and air-conditioning systems
    PROPERTY OWNER INSTALLATION Landscape lighting and sprinkler controls
    Name:       Landscape irrigation controls*
    Address:       Outdoor landscape lighting*
    City/State/ZIP:       Vacuum systems
    Email:       Other:      
    Phone: (     )       Fax: (     )       Number of systems:      
    This installation is being made on residential or farm property owned Miscellaneous fees, each additional inspection: ………………$61.50
    by me or a member of my immediate family. This property is not
    intended for sale, exchange, lease, or rent. (ORS 479.540(1) and * Exception: BCD licenses are not required only when work is done
    479.560(1)) by a licensed landscape contractor, under ORS 671.510 to 671.710.
    Sign here:      
    CONTRACTOR INSTALLATION
    APPLICANT USE
    Business name:      
    (A) Enter total of above fees $      
    Address:      
    (B) Enter 12 percent surcharge (.12 x [A]) $      
    City/State/ZIP:      
    Phone: (     )       Fax: (     )       (C) Plan review, if required (.25 x [A]) $      
    (D) Investigative Fee,
    CCB lic.:       BCD lic. no.:       $      
    if applicable, equals to (A)
    Signature:      
    TOTAL fees and surcharges: $      
    Name of signing supervisor:      
    Signing supervisor’s license no.:       Make check or money order payable to CLATSOP
    COUNTY BUILDING CODES. If paying by credit card,
    Visa MasterCard Phone: (     )       applicant must sign the credit card information box. Do not
               /      send cash.
    Credit card number Expiration
         
    Name of cardholder as shown on credit card
          $      
    Cardholder signature Amount

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