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Received <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Senator Bldg. NO. 225 <br />220 Sigh Street NE <br /> Salem~ Oregon 97301 <br /> <br /> Phone 58s-5147 <br /> CoSe-A-Phone 4=:30 EM, - 8:00 A.M. <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />Owner: '" Phone: Mailing Address: <br />Job Address: ~ ' ' Site No,: "Cross Streeb <br />Electrical Firm ~ j / ~ Addmss~ ....... <br />8up~rvislng Electrician; P~one: A~dress: .... <br /> <br />Electrical Contraetor~ NO,; " ~me Bullder~ Regi~tratio~'No.: <br /> <br />Supervlsi~' ,,, Use of Residential ~ New ~ ~'~ition ~ OcCupancy <br />Electrician's No,; Building: Ceremonial ~ Alteration ~ Relocatlon ~ Change <br /> <br /> No, RESIDENTIAL <br />__ Residence wiring lessthan 1000 sq. ft ................................. @ $ 50,00 <br />,~ Residence wiring less than ¢'000 sq, ft ................................. @ $ 75.00 <br />__.~ Residence wiring over 2000 sq. 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 Indastrial: <br />__ Service not over 100amperes ....................................... @ $ 45.00 <br />____ Sarviceoverl00amperesbutnetmerethan200amperes ................. (o~$ 70.00 __ <br />__ Serviceover20Oamperesbutnotmorethan400ampere$ ................. @$ 100,00 <br />___ Servlceever400amperesbutnotmorethan600amperes ................. (4 $ 180.00 <br />___ Serviceover600amperes ......................................... @ $ 200.00 <br />__ Service over 600 volts ............................................. @ $ 450.00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feeders: <br />__ Notmorethanl00amperes ........................................ @$ 25.00 <br />__ Over 100 anlperes but not more than 200 amperes ....................... @ $ 40.00 <br />__, Over200amperesbulnotmorethan400amperes ....................... @$ 70,00 <br />__ Over 400 amperes ............................................... @ $ 85,00 <br />__ Feederover6OOvolts ............................................. @ $ 120.00 <br /> MISCELLANEOUS <br />__ A, Eachtrallerormobilehomespece(Serviceequipment) .................. @5 25.00 <br /> B. Each supply for mobile home (Connection) ........................... @ $ 25,00 <br />~.__ C, EachirrigatIoopump(Attachamapshowinglc~cetlon) ..................... C~$ 00.00 <br />___ D, Each electric sign or octllne lighting ................................ @ $ 30,00 <br />__ E. Eachswimmlng pool(bonding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br />~__ One new circuit', alteration or extension ............................... @ $ 2(L00 <br />__ TwoormerenewcircuJts;alterationsorextensions ....................... @$ 30.00 <br />__~ Other (as per NEC and Building Official) ......................................... <br />__ On-Site Technical Review (apply directly at Marion County only) ...................... <br />__ IndustSalPlantlnspectJen(appiydirectlyatMarionCountyonly) ...................... <br />__ Reinapection Fee ................................................ @ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br /> <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> , INVESTIGATION FEE .. <br /> with the ingicated fee, FLEET SURCHARGE ~/~ <br /> /~ ~ -- TOTAL $ -*-~,-, ~ <br /> <br />[] HOMEOWNERS - I hereby certify that I am the owner of the property 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 oi" rent, <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> <br />