Laserfiche WebLink
Date ~--~/- ~ ~7 [.~,;/Salem= O~egon 97501 <br /> Code-A-Phone 4:30 RM,,- 8::00 A.M <br /> <br /> j[NG ~~AL PERMIT APPLICATION <br /> <br /> Phone;; Mailin.g.~ddres~ <br /> _ .......... <br /> Phone Address <br /> ' Phone Address, <br /> <br />Home BuildeCs Registration No,;; <br />Use of '~.;.;~C~,e-~ Residential ~,.~.r~' <br />New ~ Addition [] Occupancy <br />Building ~_y.~q~... Commercial [] Alteration [] Relocation [] Change <br /> <br />Job Address;: <br /> / <br />Electr' al Firm' <br /> <br />Supervising Electrici'an / <br />Electrical Contractor~ NC <br /> <br />Supervising <br />Electrician's NO:: <br /> <br /> No. RESIDENTIAL <br /> __ Residence wiring lessthan 1000 sq, ft @ $ 50 00 __ <br /> ..... Residence wiring less than 2000 sq ft @$ 75,00 <br /> __ Residence wiring over g000 sq,, ft @ $ 10500 <br /> Electric heat installation in existing residence @ $ 30,00 <br /> SERVICES <br /> ...... Temporary Construction Service ........................ (~) $ 30 00 <br /> __ Servicechange onlyin an existing residence @ $ 30 00 <br /> Commercial or Industrial: <br /> __ Service not over 100amperes ............. @ $ 45,00 <br /> -- Servlce over l00 amperes but not mora than 200 amperes ....... @$ 7000 <br /> __ Serviceover2OOamparesbutnotmorethan4OOamperes @$ 100.00 <br /> __ Service over 400 amperes but not more than 600 ampen~s ......... @ $ 150 <br /> __ Service over 600 amperes ............. @ $ 20000 <br /> __ Serviceover600volts .................. @ $ 45000 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br /> ~,__ Notmorethanl00amperes .......... @$ 2500 <br /> __ Over l00 amperes but not mo~e than 200 amperes @$ 40,,00 <br /> __, Over200amperesbutnotmorethan400amperes @$ 7000 <br /> ____ Over400amperes .............. @$ 8500 __ <br /> __ Feederover600voJts .............. ¢ $ 12000 <br /> MISCELLANEOUS <br /> __ A, Eachtrailerormobilehomespece(Serviceequipment) (<~)$ 2500 <br /> .... B Each supply for mobile home (Connection) .............. @ $ 25,00 <br /> __ C EachirrigationpcmptA achamapshowng o~a on) ......... (',~)$ 3000 <br /> __ D Eachelectricsignoroutlinelighting ............... @$ 30.00 <br /> __ E Each swimming pool(bonding) ....... ~ $ 3000 <br /> SRANCH CIRCUITS <br /> __ One new circuit: alteration or ex ens on ...... (¢ $ 2000 <br /> /,-'""'Twoormorenewsircuts=a eratonsorextensons ........ ~$ 3000 <br /> ....... Other (ss per NEC and Building Official) <br /> _,__ On-Site Technical Review {apply dJre¢ly at Marion Counfy only) <br /> __ IndustrialPlantlnspection(appiydirectlyatMarionCountyonly) <br /> __ Reinspection Fee ....... ~.~' $ 2000 <br /> FEE <br /> STATE SURCHARGE /, ,,-'-'~) <br /> Please return COMPLETE APPLICATION C~ ~'. ~ /, .5-"o <br /> with the indicated fee.. INVESTIGATION FEE <br /> FLEET SURCH/~GE <br /> TOTAL <br /> <br />I agree to make the electrical installation according to the submitted plans and speclflcations~ the laws of the State of Orel~pn and the Ordinances of Marion County <br />SIGNATURE OF APPLICANT ~'0~ <br /> <br />HOMEOWNERS - I hereby certify that I am the owner of the property described above: at wh ch scat on propose to make an electrical installation for <br />my own use and this proper~ is not heine ¢onstruc,[ed for sale, I e a s~.,e,~.e,~.-, <br /> <br /> <br />