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Received 8y <br /> <br />,~ARI.ON COUNTY BUILDING INSPECTION <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br /> -I~'hone Mailing Address <br /> ~ ~ ~ SiteNo.:: Cross Street <br /> <br /> Phone Address:: <br /> <br /> Phone:: Address <br /> <br />Home Builder~ Registration NO <br />r useo~ Residential ~ New ~ Addition ~ Occupancy <br />Building::_ 6¢~z~o~4 CommercialAlterati~ Relocation ~ Change <br /> <br />J°b Address:;,,/¢~' 7 ~ ,~'/I,c 4. <br /> <br />Supervisi~sian <br />Electrica~tor~ No :: <br />Supervising <br />Electrician~ No ~ <br /> <br /> No.. RESIDENTIAL <br /> __ Residence wiring less than 1000 sq ft ............ ('~3 $ 5000 <br /> __ Residence wiring less than 2000 sq ft @ $ 7500 <br /> __.__ Resideneewiringover2000sq ft .......... @ $ 105 00 <br /> <br /> SERVICES <br /> ..... Temporary Construction Service ...... @ $ 30.00 <br /> __Service change onlyln an existing residence @ $ 3000 <br /> Commercial or industrial: <br /> __ Service notover 100 amperes ................. @ $ 4500 <br /> ..... Service over 100 amperes but not more than 200 amperes @ $ 70.00 __ <br /> __ Service over 200 amperes but net more than 400 amperes ..... (¢ $ 100 00 <br /> ..... Service over 400 amperes but not more than 600 amperes @ $ 150.00 <br /> __ Service ever 600 amperes @ $ 20000 <br /> ...... Serviceover600volts @ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feedere; <br /> __ Not morethan 100amperes ......... @ $ 2500 <br /> .... Over 100 amperes but not more than 200 amperes @$ 40.00 <br /> __ Over200amperesbutnotmorethen400emperes @$ 7000 <br /> __ Over 400 amperes ............. r~ $ 8500 __ <br /> ..... Feeder over 600 volts .......... @$ 120.00 <br /> MISCELLANEOUS <br /> __ A Each trailer or mobile home space (Sen/leeesulpment) ¢ $ 25 00 <br /> __ B Eachsupplyfor mobile home (Connectton) ~.. $ 2500 __ <br /> ...... C E~chirngationpump(Attacl~amapsbowinglocatien) C~$ 30.00 <br /> __ D Eachelectricsignoroutlinelighting ..... @$ 3000 <br /> __.. E Eachswimming pool(bending) @ $ 30 00 <br /> SRANCH CIRCUITS <br /> One new circuit:: alteration or extension ......... (~$ 20.00 <br /> <br /> __ Other (as per NEC and Building Official) ..... ' <br /> __ On-Site Technical Review (apply directly at Marion County only) <br /> ..... Industrial Plant Inspectioe (apply directly at Marion Counfy only) <br /> __ Reinspection Fee ~ $ 20,00 <br /> FEE <br /> STATE SURCHARGE .... <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee,, INVESTIGATION FEE __ ,,, <br /> ~LEET SUROHARGEToTAL $ <br /> <br /> agree to make the electrical installation according to the submitted plans and spe¢lflca oas: he aws o he S a e o O egon an~ the Ordinances of Marion County <br /> <br />SIGNATURE OF APPL CANT ~To~) ~O: <br /> <br />~I'IOMEOWNERS - I hereby certify that I em the owner of the property described above: et wh ch ocat on ] propose to make an eleotricaf installation for <br /> my own use end this property is not be~ng penstructed for sa[P, lease ¢J~fect. <br /> <br />MC 15.34 ~ ~ ~/ ~ ~ (Owf~or doing h~s own work) <br />Rev 12188 <br /> <br /> <br />