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~~ Phone:: Ma~jn~l Adjilress:: <br />~ ~ .... Phone Address:: <br />In:: Phone::' Address:: <br /> <br />i No,;; ~me Builder~ Registration NO:: <br /> ......... ~ , ~ [ Al~ration ~ Ralston ~ Change <br /> <br />Job Address:: <br /> <br />Supervising Electrician:: <br />Electrical Contra <br /> <br />Supervising <br />Electricians NO:: <br /> <br /> NO. RESIDENTIAL <br /> __ Residencewidnglessthanl000sq fl ........... @$ 50.00 <br /> __ Residence wiring lenn than 2000 sq ft ......... @ $ 75.00 <br /> __ Resldencewiringover2000sg, ft ........................... @$ 105.00 <br /> __ Electric heat Installation in existing residence ..... @ $ 30.00 <br /> SERVICES <br /> Temporary Construction Service ..................... @ $ 30.00 <br /> __ Service change only in an existing residence ..... @ $ 30,00 <br /> Commercial or Irldaetrlel: <br /> __ Servlcenotover100amperes ...................... @$ 45.00 <br /> __ Service over l00 empems but not more than 200 ampems ................ @$ 70.00 <br /> __ Service over 200 amperes but not more than 400 amperes ....... @ $ 100.00 <br /> __ Serviceover400ampemsbulnctmorethan6OOamperes · .... @ $ 150.00 <br /> ___ ServiceoverS00empores .................. @ $ 200.00 <br /> __ Servi~eover6OOvolts .................. @ $ 4,5000 <br /> COMMERCIAl. AND INDUSTRIAL FEEDERS <br /> Installation of AI1eratlons or Relocation of Dlstrlb~'flon Feeders: <br /> ~ Not more than 100 ampetas @$ 25,00 ~'~- ~ <br /> ....... Over 100 ampetas but not more than 200 amperes ......... @$ 40.00 <br /> __ Over200empereebctnctmorethan400amperes ..... @$ 7000 <br /> Over 400 amperes ........ @ $ 8500 <br /> __ Feederover600volts ........... ~$ 12000 <br /> MISCELLANEOUS <br /> __ A E~chtrailerorrccJbilehoreespace(Serviceequipment) @$ 25.00 <br /> __ B Eschnupp~fOrmobilehome(Connection) ....... @$ 25.00 <br /> ___ C, Eachirrigatioflpamp(Aaechemapst~winglocation) ..... ~$ 30.00 <br /> __ D- Eschelectricsignoroutlinelighting ........... ~$ 30.00 <br /> ___ E, Eachswimmingpool(bonding) ........ @ $ 30.00 <br /> BRANCH CIRCUITS <br /> -~ One new circuit; alteration or extension ~ $ 20,00 <br /> __ Twoormorenewcimuits;alteretionsorextenslons ...... @$ 30.00 <br /> __ Other (as per NEC and BuJldlng Officlal) <br /> __ On-Site Technical Review (apply directly at Marion County only) <br /> __ Industrial Plant Inspection (apply directly at Marion County only) <br /> __ Reinspoction Fee ........... ~_a= $ 2000 <br /> FEE <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION '~-'Z~'~ /- ''~ <br /> with the indicated fee. ~ ~')'NVESTiGATiON FEE __ <br /> FLEET SURCHARGE <br /> TOTAL $ <br />,agree to make the electrical insts'l_~n accO~oi~gV'''~ to thz*~ulam~tedIl ~'1 plan~nd ~C-~f~'~ ~ ~-.-~ the State of Oregon and the O~dinances Of Marion <br />SIGNATUREOFAPPLIC~NT:: ~'~:~--&~'~.~,~'.'.~ [~ : ~ ,.]-ob NO: <br /> <br />L~ HOMEOWNERS - l hereby certih/that I am the owner of the property described above, at which location I prepose to make an electrical installation for <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> <br />