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Received By'. <br /> <br />Date; ___ <br /> <br /> ' N <br />MARION COUN'[Y BUILDING INSPECTIO <br /> ;3enator Bldg, No. 225 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> Phone', Mailing Address: <br /> ,, Cro~s Street: ...... <br /> <br /> upervising Electrician: <br /> <br /> ractor'5 Na.:.,~,,, o~ -,~/" ~ <br /> <br />I supervialng Useof <br />L, Elect rician's No,'.] z//~ 7 %.4~ Building: <br /> <br /> Address; <br /> <br /> Address; <br /> <br /> Home Builder's Registration NO,: ~ ! ~' / ~ <br /> <br />Residential ~¢' New [~ Addition Iq <br />Commercial[7~ Alteration [] Relocation [] <br /> <br />Occupancy <br />Change L~ <br /> <br /> No, RESIDENTIAL <br /> Residence wiring Iaaa than 1000 sq. ft ................................. @7 $ 50,00 <br />__ Residencewiring iaea than 2000 sq. It ................................. ((.~ $ 75,00 . <br />___ Residence wiring over 2000 sq, ft .................................... ~ $ 105,00 __ <br />__ Electric heat installation in existing residence ........................... ~ $ 30,00 <br /> SERVICES <br />__ Temporary Construction Service ..................................... (q~ $ ;30.00 <br />__ Service change only in an existing residence ........................... ('~. $ 30.00 <br /> Commercial or industrial: <br />....... Service f~ot over 100 amperes ....................................... (~! $ 45.00 __ <br />___ Servlceoverl00amperesbutnctmerethan200amperes ................. (_&.~$ 70.00 <br />__ Serviceover200ampereabutnotrnorethana00~mperea ................. (¢$ 100.00 <br />..... Service over a0o amperes but not more than 600 amperes ................. ~!$ 150.00 <br />.... Service over600 amperes ......................................... (~_ $ 200.00 <br />__ Service 0ver600volts ............................................. @~ $ 450,00 __ <br /> COMMERCIAL AND INDUSTRIAl FEEDERS <br /> ~llstallation of Alterations or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes ........................................ @ $ 25,00 __ <br />__ Over 100 amperes but not more than 200 amperes ....................... C_¢ $ 40,00 <br />__ Over 200 amperes but not more than 400 amperes ...... . ................. (-~_ $ 70.00 <br />..... Over 400 amperes ............................................... ('a~$ 85.00 <br />........ Feederover600velta ............................................. ~_. $ 120.00 <br /> MISCELLANEOUS <br /> A. Eachtrailerorrnobilehomespace(senaceeCluiernen0 .................. ¢_e?$ 25.00 __ <br /> S. Each supply for mobile home (~onnection) ........................... (~ $ 25.00 <br />__ C. Each irrigation pump (Aa,3ci~ a map showin9 location) ..................... (~. $ ;30,00 __ <br /> D. Each electric sign or outline lighting ................................ (~¢ $ 30.00 <br /> E. Eachswimmiagpoct(bondieG) ................................... ~_c~$ ,30.00 <br /> BRANCH CIRCUITS <br />.... One new circuit; alteration or extension ............................... (q~ $ 20.00 <br />___ Two Or more new circuite; alterations or extensions ....................... (~ $ 30,00 <br />..... Other (as per NEC and Building Official) ......................................... <br /> On-Site TechniCal Review (apply dlrectly at Marion Counb/only) ...................... <br />__ Induetrlal Plant Inepectlon (apply directly at Marion County only) ...................... <br />__ Reinspectlon Fee ................................................ _¢) <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> <br /> with the indicated fee. INVESTIGATION FEE ~ <br /> FLEET SURCHARGE <br /> TOTAL $~L~_~ ~ <br /> <br /> --r~/ <br /> ~ described above, at which location I pmpo~ to make an electdca nsta at on for <br />my own use and this property is not being constructed for s~, Ieee or rant, <br /> <br />MC 15-~4 <br />Rev, 12188 <br /> <br /> <br />