In Canada the service comes into the house on 3 wires, a neutral and two hot wires. In Sask. the neutral and ground are tied together at the breaker panel, although this may differ in other provinces. Between the hot wires is ~240V and between the either hot and the neutral is ~120V (opposite phase from each other). Those paired breakers you see is because the power bars in the breaker box alternate between the two hot wires, so that every other breaker is on the same line. This means a pair of breaker slots side by side can be used to supply 240V, and any single slot can be used for 120V. The pairs you see over 15 amps will be to supply the stove, subpanel or other large 240V loads. You will also see 15 amp pairs. These will be for split duplex plugs in the kitchen. On these the neutral and both hots are carried in a 3 core cable (+ ground) allowing a single duplex receptacle to have 2 circuits. This way you can plug a kettle into the top plug and a toaster in the bottom plug without blowing the breaker. In Germany my panel was 3 phase and it was similar, every 3rd slot in the breaker box was on the same line. The 3 phase loads took triple wide breakers.The odd thing when you look is many are paired breakers which I think is to allow 110V to be taken for some of the circuits (lights and controls) in the appliance while the 220V power does the main work