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Received By: <br />Date: <br /> <br />MARION COUNTY, BUILDING iNSPECTION <br /> ~n~r BI(ID, NO. 225 <br /> 220 H~gh St]~e~NE <br /> <br />ELECTRICAL PERMIT APPMCAT ON <br /> <br /> Owne~'; / 'Phone: Address: <br /> <br />~tus AddresS: I Site NO.: Cross Stm~:" <br />/ W ~.~, AddresS: · : <br />Electrical Firm: Phone: <br /> ~&so~s lac. 363-4[4[ , ~.0. ~'o~ '126~9 ~a[em, OA 97309 .,, <br /> Supen/Islng Electrician: Phone; Address: ' <br /> <br /> DoA,_~hl ~me Same , ,,, <br /> Electrical Contra~or~ No.: Home Bu bor~ Registration No,: ' <br /> 24-18C 34604 ' <br /> Use of New ~ .... Addition . ~ O~upancy <br /> Supervising Bud ng:, ~ Alteration ~ Re ocet on ~ Change <br /> <br /> NO, RESIDENTIAL <br /> =lesldence wiring less than 1000 sq. ft ................................. @ $ 30.00 <br /> ;~eaidence wiring lass than 2000 sq. ft ................................. @ $ 50~00 <br /> ;~esidence wiring over 2000 sq. f~ .................................... @ $ 70.00 <br /> Electric heat installation in existing residence ........................... @ $ 20,00 <br /> SERVICES <br /> Temporary Construction Service ..................................... @ $ 20,00 <br /> Service change only in an existing ~estdence .......................... @ $ 20;00 .._ <br /> Commercial or Industrial: <br /> Sen/ce not over 100 amperes ....................................... @ $ · 30,00 <br /> Sen/ice o~r 100 amperes but not more than 200 amperes . ......... @ $ ' 50.00 <br /> Se~ice over 200 amceres but not more than 400 amperes ................. @ $ 70.00 <br /> Service over 400 amperes but not more than 600 amperes ............... @$ 100.00 ..... <br /> Service over 600 amperes ........................................ @$ 130.00 <br /> San/Iceo'A3r 60¢ volts ............................................. @ $ 300.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Altaratlons or Relocation of Distribution Feeders; <br /> I,Iot more than 100 amoerea ........................................ @$ 20.00 <br /> Over 100 amperes but not more than 200 amperes ..................... @ $ 30.00 <br /> Over 200 amperes but not more than 400 amperes ....................... @ $ 50.00 <br /> Over 400 amceres ............................................... @ $ 60,00 <br /> Feederover600volts ............................................ @ $ 80.00 <br /> MISCELLANEOUS <br /> A. Each trailer or mobile home space (Service equipment) ................. @ 9, 80.00 <br /> g, Each supply for mobila home (Connexion) .......................... @ $ 20,00 <br /> C. Each irrigation pump (A~a~h a map ~howing lOCation ..................... @ $ 20,00 <br /> D, Each electric sign or outline lighting ................................ @ $ 20.00 <br /> E. Each residential swimming pool ................................. @ $ 20.00 <br /> BRANCH CIRCUITS <br /> ,/ One new clmul~; alteration or extension ........ .~...~.,..~.. (((..~"~. ........ @$ 15,00, <br /> Two or more new cimuits: alterations or extensions ....................... @ $ 20.00 <br /> Other (as per NEC and Building Official) ......................................... <br /> On-Site Technical Review ~app[y directly at Marion County only) ..................... <br /> industrial Plato tnsaection (apply directly at Marion County only) ..................... <br /> Reinspection Fee ...................................................... ~EE /~'~ ~ <br /> STATE SURCHARGE ' · ~'~-,'~ <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> NVESTIGATION FEE <br /> with the indicated fee. FLEET SURCHARGE <br /> TOTAL <br /> <br />SfGNATUREDFAPPLICANT:Iagteet° nlaP~etheelectrlcalinstallatl c~'~7~: ~ 7~-?~,[(Supervtsng£ect can,cllnpt°lhesubmittedple o+ands ~ifl tic s lnelawsofrhe3tateotOregonandtheOndinsnoe~0fMsriar County <br />[] HOMEOWNERS - { hereby certify that I am the owner of the prope~y descr bed above at which Iocazion I propose to make'an electrical installation for <br /> my own aaa and this property is not being cenatructed for sale lease or rent. <br /> <br /> SIGNATU R E OF APPLICANT; .... <br /> (Owne~ dolr~ ~18 own wom~ <br /> MC 15-34 <br /> Rev, 3/87 <br /> <br /> <br />