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Reaeived By: __ <br />Cate; <br /> <br />MARION COUNTY B~IILDING INSPECTION <br /> Senator Bldg, NO. 225 <br /> 220 High Street NE <br /> <br /> ELECTRICAL PERMIT APPLICATION _~.~' <br />Owner' ~3 ! -- -- ~ Ph~r~:~. Msillng Address; <br /> <br /> '-- 'Sit~ ' Cross Stm <br />Electrical Firm: ' ' -'~ ' ' ' Address; <br />JsJng Ete~rici~ Phone: I <br /> <br />Supe~v~sin,,g --~'~--' J uaeet <br /> No, RESIDENTIAL <br /> <br />Residential E] New <br /> <br />Residence wiring less than 1000 sq, f~ ................................. @ $ 50,00 <br />Residence wiring less than 2000 sq. ft ................................. @ $ 75,00 <br />Residence wiring over 2000 sq. ft .................................... @$ 105.00 <br />Electric healinstallation 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 Industrial: <br />Servicenotoverl00amperes ....................................... @$ 45.00 __ <br />Se~ice over 100 amperes but not more than 200 amperes ................. @$ 70,00 <br />Serviceovera00amperesbut net mon~ than 400 amperes ................. @ $ 100.00 <br />Service over 400 amperes but not more than 600 amperes ................. @ $ 150,00 <br />Serviceover 6{30 empires ......................................... ¢! $ 200.00 <br />Serviceover600volts ............................................. (~/$ 450.00 __ <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br />InstallatiOn of Alterations or Relocation of Distribution Feeders: <br />Not mere than 100 amperes ........................................ @ $ 25.00 <br />Over 100 amperes but not more than 200 amperes ....................... @ $ 40,00 <br />Over 200 amperes but not mom than 400 amperes ....................... £4) $ 70.00 <br />Over 4.00 amperes ............................................... @ $ 85.00 <br />Feeder over 600 vsits ............................................. @$ 120.00 <br /> MISCELLANEOUS <br />A. Eechtrailerormobilehomespace(Serviceequiprnent) .................. ¢~>$ 25.00 <br />S. Eaahsupplyformobtlehome(Connection) ........................... @$ 25.00 <br />C, Eachirrigationpump(Attacharnapshowtngloeation) ..................... @$ 30,00 <br />D. Eachelectricsignorout~inetighting ................................ @$ 30,00 <br />E, Each swimming pool (bonding) ................................... (~) $ 30.00 <br /> BRANCH CIRCUITS <br />One P~w Circuit; -3.[ter&t~0rt or extension ............................... (~ $ 20.00 <br />Two or mete new circuits; alterations or extensions ....................... @ $ 30.00 <br /> <br />Addition <br />Re[oostion <br /> <br />Occupancy <br /> <br /> ..... Other (as per NEC and Ssilding Official) ......................................... <br /> __ On-Site Technical Revlew (apply directly at Marion County only) ...................... <br /> __ Industrial Plant Inspection (apply directly at Marion Cou~lty only) ...................... <br /> ..... Reinspectlon Fee ................................................ @ $ 20,00 <br /> FEE <br /> STATE SURCHARGE ~-' ~'-'~ <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> INVESTIGATION FEE -, ~- . / <br /> Wi~ the indicated fee. <br /> FLEET SURCHARGE ,,, <br /> TOTAL <br /> <br />$i~NATUR~ Otc APPLICANT: ~ ~~ ~To~) <br /> HOMEOWNERS - I hereby certify that I am the owner of the prope~/described above, at which Iooation I propose to make an electrical installation for <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />MC <br />Rev. <br /> <br /> <br />