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MARION COUNTY BUILDING INSPECTION <br /> <br />~enatOr eidg. No. 225 <br />220 High Street NE <br />Salem, Oi'egon 97301 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner: ~, r,. :, ' , .... - -- Phone: M,~3)ling A~dress: <br />Ele~ric~ Phone: Address: <br />Supervising EJe~frician: Phone: Addre~; <br /> <br />Electrical Contract0r~ NO,: Home Builder~ Registration No.: <br /> I ~%ew ~ Additio* <br />Supervising Useof ~ i Residential Oooupen~y' <br />El~rician's No,; Building;~ .... f~m{wl _. } Oommemia[ ~ [ Alteration ~ Relocation ~ Change <br /> <br /> NO. RESIDENTIAL <br />__ Residenoewiringlessthanl000sq. ft ................................. @$ 50.00 <br />.... Residence wiring less than 2000 sq, ft ................................. ~ $ 75,00 <br />__ Residencewlrlngover2000sd, ft .................................... @$ 105,00 <br />___ Electric heat installation in existing residence ........................... L~ $ 30,00 <br /> SERVICES <br />___ Temporary Construction Service ..................................... @ $ 30.00 <br />__ Service change only in an existing residence ........................... @ $ 30.00 <br /> Commercial or Industrial: <br />__ Service not over 100 amperes ....................................... ~ $ 45,00 <br />__ Serviceoverl00amperesbutnotmorethan200amperes ................. @$ 70.00 <br />.... Service over 200 amperes but n0t mere than 400 amperes ................. @$ 100,00 <br />__ Serviceever400amperesbutnetmorethen600amperes ................. @ $ 150,00 <br />__ Serviceover600amperes ......................................... @ $ 200.00 <br />__ Service over 600 volts ............................................. ~ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Netmorethan 100amperes ........................................ @ $ 25,00 <br />__ Over 100 amperes butnet more than 200 amperes ....................... @ $ 40.00 <br />__ Over200smperesbutn0tmorethan400amperes ....................... @$ 70,00 <br />__ Over400ampere~ ............................................... @ $ 85.00 <br />__~ Feederover600volts ............................................. @$ 120,00 <br /> MISCELLANEOUS <br />__,__ A, Eachtrailerormebilehomespace(8er¥lcee~uipment) .................. @$ 25,00 <br />__ B, Eachsupplyformobilahome(Conne¢tion) ........................... ~$ 25,00 <br />-- C. Eachirrigatlenpump(Ana~hamapshawlngloc~tio~) ..................... @$ $0.00 <br />~_ D, Each electric aJgn or oulline lightlng ................................ @$ 30,00 <br />__ E, Eachswlmming pool(bonding) ................................... @ $ 30,00 <br /> SRANCH CIRCUITS <br /> One new cJret~[t; alteration or extension ............................... @ $ 20,00 <br />~ Two or more new oireulta; alteratlons or extensions ....................... ~ $ 30,00 <br />__ Other (as per NEC and Building Official) ......................................... <br />__ On. SJteTechnicalRevJew(applydirectlyatMario~Countyonly) ...................... <br />___ Industrial Plant Inspection (apply directly at Marion County only) ...................... <br />__ Reinspection Fee ................................................ (r~ $ 20.00 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br />with the indicated fee. ~ $~ <br /> TOTAL <br /> <br />~HOMEOWNERS - I hereby certify that [ am the owner of the proper~ described above, at which location I propose to ma~e an electrical installation for <br /> <br />my own usa and this property is not being constructed for sale. lease or rent. <br /> <br /> <br />