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OFRC~ L~EONLY <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTIC~ <br /> <br /> Salem, Oregon 97301 <br /> <br />Phoee 588-5147 8.'00 a.m. - 4:30 p.m. <br />Cede.A-Phoee: 588-7904 <br /> FAX: 588-7948 <br /> <br />D}'re,=lona: <br /> <br />2A. ~ 1~31'ALLATI~I OflLY <br /> <br />SULLIVAN ts ELECTRIC CO INC. <br /> 97 ..S <br /> <br />Property Owner <br /> <br />Contr,~c~or's1 L~c~e No. <br />Contractar'~ Soar~ Reg. No. I Job No. <br /> 44344 <br /> I <br />STgn~ture of SupetyIsing Elec~lan ~ ~. _ <br /> <br />Phone <br /> <br />Ptoper~Owner <br /> <br />Ma[ting Addre~e <br /> <br />City/State/Zip <br /> <br />The installation Is being made on property I own which is not Lntended tot sale, <br />lease Or renlL <br /> <br /> Dam: ~'~;At¢ION COUNTY <br /> Iseu~dby: u:~u~,~u I~'SPECTION <br /> <br />4. FEE SCHEDULE (Complete and enter total in At below) <br />~lumber e4 InlpeetJons per permit allowed <br /> <br />A. Re$1dantlal, Singleer Iteme x Cost = T~I~I <br /> <br />Multi,Family per dwelling unit <br /> <br /> 1500 sq. fl. et tsas <br /> ~ ~'1 ~0 ~- ~. ~ posen <br /> E~ Mfg,'d Ho~ er M~r <br /> O~lllng ~ or f~r <br /> <br /> R~nn~ Only <br /> <br /> S~n~ si~it(~) er a ~t~ ane~y <br /> <br />F, E~h add'l ths~e~on <br /> ~er ~a ~l~ts in any of <br /> <br /> P~k of 10 ~ls ~ $5.~ <br /> <br />__SOS, 4 <br />__$~5. <br /> <br /> $35. 2 <br /> 7 ........ s~o.__ = <br />__$80,__ 2 <br />-- $1a0, __ 2 <br />,~00. 2 <br /> <br />$40.__ 2 <br />$~0.__ 2 <br /> <br />$35.__ 2 <br />$50,__ 2 <br />__$15. 2 <br /> <br />pLAN REVIEW SEC'~C)N <br /> Check approp~te ilam and enter fee in Sec~on <br /> <br />__ Connected Load over 200 amps (except single family dwellings) <br />__ Building system over ~ amps (except single family dwellings) <br /> System over 600 volts <br />__ Building over 2 s~des <br />__ Buil,'~ng over 10,000 square feet <br />__ Occupent Ioed over 300 persons <br />__ Manufac~umcl Dwelling PaddRecm~on Pa~k <br /> Hazan:lous Locations <br /> <br />:Submit 2 sets of plans with any of the above. <br />Temporary construc'dee services do not apply. <br /> <br />Al. Enter total of fees from ~eo, ~ <br />A~. Addb"% surcharge (.05x A~) <br /> <br /> Subtotal <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (See. 3~), if required <br />G. invosdgh, tiee Fee (if mquirod) <br />D. Reinspec~on Fee ($25,00) <br /> <br /> q'OTAL AMOUNT DUE <br /> Receipt No. <br /> <br /> <br />