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Received By __ <br />Date <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg NO, ~5 <br /> 220 High Street NE <br /> Salem~ Oregon 97301 <br /> <br /> Phone ~88-5147 <br /> Code-A-Phone 4::30 RM. - 8;;oe A.M, <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />j~q.n_d & Pe~_r_i_c..ia Forson <br /> ob Address' <br /> <br /> 11672 Warbler Ln. N.E. A~urora,Or 97002 <br /> Electrical ¢irm <br /> <br /> Parkin Electric <br /> <br />Phone <br />665-55.3¢9~ <br /> <br />Site No,,;: <br /> <br />Phone:: <br /> <br />246-1301 <br /> <br />Supervising Electrician:: Phone' <br />Harr~__P.arkin Same <br /> <br />Electrical Contractor's NO, <br />34-4C <br />Super~,ising Use of Single <br />Electrician's__.__No 896S, Building Dwellinq <br /> <br /> No, RESIDENTIAL <br /> <br />Mailing Address:: 97060 <br />20145 NE Sar~v~_~!_T~Eoutdale, Or <br />Cross Street <br /> <br />Address <br />Rt. 5 BOX 79K Sherwood,_O~,_ 97140 <br />Address <br /> <br />Same <br /> <br />Home Builders Registration No:: <br /> <br />35151 <br /> <br />Residential ~ New U Addition L~ Occupancy <br />Commercial ~ AlterePon [] Relocation [] Change <br /> <br /> ___ Residence wiring lessthan 1000sq ft (fi) $ 5000 <br /> Residence wiring less then 2000 sq ft 0:' $ ?500 <br /> __ Residence widog Over 2000 sq ft ¢) $ 10500 <br /> ___ Electric heat installation in existing residence (~:, $ 30 <br /> SERVICES <br /> -- TemporaryConstruotionService (~$ 30,00 <br /> Service change onlyin an existing residence ((~ $ 3000 __ <br /> Commercial or Induetrial: <br /> Service not over 100amperes ¢, $ 4800 __ <br /> .__ Serviceoverl00amperesbutnotmorethan200amperes (ii,$ 7000 <br /> __ Service over 200 amperes but not more than 4.00 amperes ¢ ~ $ 100 00 <br /> __ Service over 400 amperes but not more than 600 amperes e, $ 18000 <br /> Service over 600 amperes (p, $ 20000 __ <br />__ Service over 800 volts (~s $ 450,00 <br /> COMMERCIAL AND INdusTRIAL FEEDERS <br /> Installation of Alteraflooe or Relocation of DJstrJbetioa Feeders <br />__ Not more than 100 amperes e~: $ 2500 <br /> Over l00 amperes bur not more than 200 amperes (if $ 4000 <br />-- Over200amperesbutnotmorethan400amperes ('¢¢$ 7000 <br /> Over400 amperes (~ $ 85,00 <br />__ PeederoverC00volts t(l'$ 12000 <br /> MISCELLANEOUS <br /> 1 A Each trailer or mobile home space (Service equipment) <br /> 1 S, Each supply for mobile home (Connection) (~ $ 2500 <br />_____ C Each irdgation pump A achamapshowng ocaton) ¢_~$ 3000 <br />.... D EaCh electric sign or outline lighting ...... ('~' $ 3000 <br />__ E Eachswimmingpool bonding) (i/=$ 3000 __ <br /> BRANCH CIRCUITS <br /> One new circuit alteration or extension (<iS 2000 <br />__ Two or more newc rcM ts= a era one or extensions (~ $ g0 00 __ <br />___ Other (as per NEC and Building Official) <br /> On-Bite Technical Rewew (apply directly at Marion County only) <br />___ Industrial Plant Inspection (apply directly et Marion County only) <br /> Reinspection Fee (~: $ 20 00 <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 ~ <br /> I agree to make tho electrical installs Ion a rdln tot bmitted plans and spec,ficatlons: tile laws of the State of Oregon and tile Ordinances of Mar onOounty <br /> <br /> SIGNATUR~ O~ APPLICANT_ . <br /> <br />[~ HOMEOWNERS - I hereby certify theft am the owner of th"&~:~O,Serty described above, at which location I propose to make an electrical installation for <br /> my Own use and this property is not being constructed for sale, lease or rent <br /> <br />SIGNATURE OF APPLICANT __ <br /> <br /> <br />