height: 12pt;" CLASS="Normal">City of Milwaukie

6101 SE Johnson Creek
Blvd., Milwaukie OR  97206

Phone: (503) 786-7613, Fax: (503) 786-7612, Inspection
Line: (503) 353-4720

 

Type  of 
Work

New construction  Addition/alteration/replacement

Other:

Category 
of  Construction

1- and 2-family dwelling  Commercial/industrial  Accessory building

Multi-family  Master builder  Other:

JOB 
SITE  INFORMATION  AND  LOCATION

Job no.:

Job address:

City/State/ZIP:

Suite/bldg./apt. no.:

Project name:

Cross street/directions
to job site:

 

Subdivision:

Lot no.:

Tax map/parcel no.:

Description 
of  work

 
 

  Property  owner

  TENANT

Name:

Address:

City/State/ZIP:

Phone: ()

Fax: ()

Owner installation: This installation is being made on property that I own, which is
not intended for sale, lease, rent, or exchange.

Owner signature: Date: 

  Applicant

  Contact  person

Business name:

Contact name:

Address:

City/State/ZIP:

Phone: ()

Fax: ()

E-mail:

Contractor

Business name:

Address:

City/State/ZIP:

Phone: ()

Fax: ()

E-mail:

CCB lic. no.:

Electrical lic. no.:

City or metro lic.:

Supervising
electrician signature, required:

Print name:

Date:

Authorized signature:

Print name:

Date:

q  Fire pump

q  Emergency system

q  Addition of new motor load

   of 100HP or more

q  Health care facilities

q  Hazardous locations

q  Recreational vehicle parks

q  Marinas and boatyards

q  Floating buildings

q  Six or more residential units

q  Supply over 600 volts

     nominal</span><span class="Style3--Char">Plan 
Review

q Building
over three stories

q Service or feeder 600 amps or over

q Commercial-use
agricultural buildings

q  Installation
of 75 KVA or larger            
separately derived system

q
"A," "E," "I-2," "I-3" occupancies

q Service
or feeder 400 amps or more where the available fault current exceeds
10,000 amps at 150 volts or less to ground, or exceeds 14,000 amps for
all other installations

 

Fee 
Schedule

Description

Qty.

Fee

Total

*

Residential single- or multi-family dwelling unit. 

Includes attached garage.

 

1,000
sq. ft. or less

 

159.00

 

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