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Reaeived By:: <br /> <br />M~ARIO~ COUNTY BUILDING INSPECTION <br /> ~._ ~nator Bldg, No. 225 <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> Phone 588.5147 <br /> Code-A-Phone 4::$0 EM.. 8::00 A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />1~;'TARION COUNTY <br /> iNSPECTION <br /> <br />I Owne,,~ <br />~ jab.~,ddresa <br /> <br />L£./'l.] - ~"5 L.f'7,¢//1.~ Phone:: MailingAddress;; <br />~__~,~ ~:?( .~JCE¢S¢7// SiteNo:: ~,~/.~) CrossStree,;; <br />Firm ' · Phone ' - Address:; <br />iSing Ele~ian:: 'P~one:: Ad%~ <br /> Contra~or's No? HSme Bullder~ Registration NO:: / <br /> <br />g ~ ~ ~ ~ e o Res[dent[~l ~' New ~ Addltio~ ~ O~upa~cy <br />Commem~al ~ Relocation ~ <br />:ia.~ No,:: ~J ~3 ~ Building:;A ~era~ on = Change .... = <br /> <br /> No. RESIDENTIAL <br />__ Residence wiring less than 1000sq ft ............ @ $ 50.00 <br />.... Residence wiring less than 2000 sq, ft @ $ 75,00 <br />__ Restdencewiringover2OOOsq ff @$ 10500 <br />__ Electric heat installation in existing residence .................. @ $ 30 00 <br /> SERVICES <br />__ TemporaryConstructionService @ $ 3000 <br />__ Service change onlyin an existing residence @ $ 30,00 <br /> Commercial or Industrlah <br />__ Service notover 100amperea @ $ 4.800 <br />__ Service over l00 amperes but not more than 200 arnperes ................ @$ 70,00 <br />__ Serviceover200amperesbqtnotmorethan400amperes @ $ 10000 <br />__ Serviceover4OOamperesbutnotmorethan6OOamperes ............. @$ 15000 <br />..... Service over 800 amperes @ $ 20000 <br />__ Serviceover600volts @ $ 450,,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Not morethan 100amperes ............................................ @ $ 25,00 <br />__ Over 100 amperes but not more than 200 amperes @ $ 4000 <br />__ Over200ampereabateotmorethan400amperes @$ 7000 <br />__ Over400amperes ............................................................ @ $ 85.00 <br />__ Feederover600vctts ......... @ $ 120.00 <br /> MISCELLANEOUS <br />__ A Each trailer ar mobile home apace (Service equipment) @ $ 25.00 <br />__ B Eachsupplyformobilehome(Connectlon) .................. @$ 25.00 <br />__ C Eachirrigationpump(Attachamapsl~owinglocation) ............... @$ 30,00 <br />.... B Each electric sign or outline lighting @ $ 3000 <br />__ E Each swimming pool (bonding) @ $ 30,,00 <br /> BRANCH CIRCUITS <br />..... One new circuit, alteration or extension @ $ 20.00 <br />__ Two or more new circuits; alterations or extensions ~ $ 3000 <br />.__ Other (as pe~ NEC and Building Officlal) <br />__ On-Site Technical Review (apply directly at Marion County only) <br /> Industrial Plant Inapectlon (apply directly at Marion County only) <br />__ Reiespection Fee (i~ $ "000 <br /> FEE <br /> STATE SURCHARGE <br />Please return COMPLETE APPLICATION PLAN REVIEW FEE <br />with the indicated fee, INVESTIGATION FEE <br /> FLEET SURCHARGE <br /> <br /> TOTAL t ........ <br /> <br />SIGNATUREOFAPPLIOANT~r~ J ~7-~ ~ -~¢.:~4-. ~ aO~ NO: <br /> <br /> HOMEOWNERS - I hereby certi~ that I am the owner of the properly described above, at which location I ~pose to make an electrical installation for <br /> my own use and this prope~ is not being constructed for sale, lease or rent <br /> <br />SIGNATURE Of APPLICANT:: <br /> <br />MC 15-$S (Owner doing his own work~ <br />Rev 1~/88 <br /> <br /> <br />