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Received Sy <br />Date ___ <br /> <br />Owner:: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator BidS. NO,, 225 <br /> 220 HISS Street NE <br /> Salem, Oregon 97901 <br /> <br /> Phone 588-5147 <br /> Code-A.Phone 4;a0 P.M,,- 8:00 AM <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />BU/LOIAt,,. OUN)~v <br /> <br />Phone::/~/.~,~-f, Mailing Address:; <br /> <br />Cross Street <br /> <br />Phone <br /> <br />Supervising Electrician:: <br /> <br />ectrician'sNo C(~.~ ~/,~ I Building <br /> <br /> No, RESIDENTIAL <br /> __ Residence wiring less thee 1000 sq ft ....... @ $ <br /> __ Residence wiring less than 2000 sq ft ...... @$ <br /> __ Residence wiring over 2000 sq ft @ $ <br /> Electric heat installation in existing residence @$ <br /> SERVICES <br /> __ Temporary Censtrumion Service @ $ <br /> __ Service change only in an existing residence (q) $ <br /> Commercial or Industrial: <br /> __ Service not over 100 amperes ¢0 $ <br /> Service over 100 amperes but not more than 200 amperes @$ <br /> .... Service over 200 Amperes but not more than 400 amperes .... @ $ <br /> __ Service over 4g0 amperes but not more than 600 amperes ...... @$ <br /> ___ Service over 600 amperes ....... @ $ <br /> Service over 600 volts ................ @ $ <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> installation of Alterations or Relocation of Distribution Feeders: <br /> ......... Not more than 100 amperes @ $ <br /> __ Over 100 amperes but not more than 200 amperes @$ <br /> __ Over 200 amperes but not more than 400 amperes (-a~$ <br /> __ Over 400 amperes .......... @$ <br /> .... Feeder over 600 volts ............. @ $ <br /> MISCELLANEOUS <br /> ..... A Each trailer or mobile home space tServlce equlpraent) ..... @$ <br /> __ B Each supply for mobile home (Connection) ............... @ $ <br /> ...... C Each irrigation pump (Attach a map showing location) @ $ <br /> __ D EachelectrlcsignoroutllnelightJng .......... @$ <br /> ___ E Eachswimmingpool(bonding) .... @$ <br /> BRANCH CIRCUITS <br /> __ One new oircu : a era ion or extension Cd> $ <br /> __ Two or more new cimuits; alterations er extensions @$ <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee,, <br /> <br /> Phone;: Address <br /> <br /> Home Builder's Registration No <br /> <br />Residential ~ New ~ Addidon <br />Commercial ~ Alteration ~ Relocation <br /> <br />5000 <br />75 O0 <br />10800 <br />30,00 <br /> <br /> 3000 <br /> 30,00 <br /> <br />45,00 <br />7000 <br />10000 <br />150 00 <br />200 O0 <br />45000 <br /> <br />2500 <br />4000 <br />70.00 <br />8500 <br />12000 <br /> <br /> 2500 <br /> 25 O0 <br /> 30 O0 <br /> 30 O0 <br /> 30 00 <br /> <br /> 20,00 <br /> 3000 <br /> <br />____ Other (as per NEC and Building Official) .... <br />__ On. Site Technical Review (apply directly at Marion County only) <br />__ Industrial Plato Inspection (apply directly at Marion County only) <br />__ Reinspection Fee ((_< $ 2000 <br /> .~-~TATE SU RC HARCGE. EE <br /> PLAN REVIEW FEE <br /> INVESTIGATION FEE <br /> FLEETSURCHARGE <br /> TOTAL <br /> <br />Occupancy <br />Change [] <br /> <br />~ HOMEOWNER~ - I hereby certify that I am the owner of the property described above, at which Io~ion I propose to make an ele~rical installation for <br /> my own use and this property i~ ~ot being ~nstructed for sale Ieee or rent, <br /> <br /> <br />