Laserfiche WebLink
~ <br /> <br /> ELECTRICAL PERMIT APPLICA11ON <br /> p~;ase comp/eta a//Sect/ons, 1through 5 <br /> <br />1. LOC.~ON OF INSTALLA'IlC)N <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, ~Oregon e7301 <br /> Phose 588-5147 8.00 am. - 4::30 p.m. <br /> ~hone: 58~7904 SiTE #: <br /> FAX:: 588-7948 Date: <br /> <br /> Issued by;; <br /> <br />Permit No.. <br /> <br />Job Addtess~8~, 205 Evergreen Dr. <br />Cl~YAttm~'~r'; ~[1 ~ I Cross St. <br /> <br /> 3udson's, Inc. <br />Mailin Address <br /> .... ~390 13th St. .S.E. <br /> <br /> Property Owner <br /> Evergreen Property Mng. David Hau~/W Moore <br />Contractor's License No. <br /> 24-18C <br /> <br />_ 34604 <br />~ig~ture of ~upervlslng E[ectdc[a~ ~ <br /> <br /> I <br /> <br />FOR OWNER ~STALLAT1ONS <br /> <br />Mailing Address I Phone <br /> <br />Clty/State~ZIp <br /> <br />The I~sr~Jlatlon is being made on property I own which is not intended for ~le, <br />lease or rent,, <br /> <br />Owner's Signature <br /> <br />3. PLAN REV~ SECI1ON <br /> Check appropria~ item and enter fee in ,~,ecEon 5B. <br /> <br />~ Connected Load over 200 amps (except single family dwellings) <br /> . Buildii~g system over 200 amps (except single family dwellings) <br />__ System over 600 volta <br />__ Building over2 stories <br />__ Building over 10,0oo squa~9 feet <br />__ Occult Icad over 300 persons <br /> <br />~ Hazardous t-om~ns <br /> <br /> Submit 2 sets of plans with any of the above. <br /> Tempora~/construofion services do nat apply. <br /> <br />4. FEE SCHEDULE (Complete ;md enter total in At below) <br />Number of in~peoUons per permit allowed · <br /> <br />A. Residential, Single or Items x C.~t = Tote[ <br /> <br />Multi-Family per dwelling unit <br />($e~W~ includ~ <br /> 1500 SCl,, fL or less <br /> Each aGIdal ~00 ~q, fl, or podios <br /> Each M fg.ad Home or Modular <br /> Or, ling sew[ce o¢ teede~ <br /> <br />B. 5ervtse/Feeders <br />(10 Branch Circuits IncLuded) <br />Ir~tallaiten, Ait#ra~ons or RelocaUon <br /> <br /> 'tOo ex'aps or less <br /> 1Ol ampc te 400 ¢u*nps <br /> <br /> 601 amps to 1000 amps <br /> Over 1000 amps or Volts <br /> Resenn~--t O~ty <br /> <br />C. Tsmpem~ ,S'ervlces/Feetlara <br />/n~taltai~n. Aitera~on er Reloc. a~en <br /> 200 amp~ or less <br /> 201 an~s te 400 amps <br /> 401 en~s te 600 amps <br /> Qve~ 600 amps of 1 <br /> <br />D. Branch C[mults <br />New, Altera~on or Ex~nsten Pe~ Panel <br /> One ¢imul! <br /> Two to mn dteults <br /> Each add'l ten =imuits or portion <br /> <br />E. Mlsselleneou~ <br />(Semite ~ Feeder not included) <br /> Each pump or Irrigation cycle <br /> Each sign or outline lighting <br /> Si~na~ ¢i[cLdt(s} ~[ ~t limited anally <br /> panel, alteration a~ extension <br /> <br />F. Each add'l Inspe~tten <br /> Over the aJlowabla in any of <br /> ~ha above, pet <br /> <br />G. Miner Ine*"llsBun L~bets <br /> Pack of 10 labels @ $5,00 each <br /> (Sold Only te elec~ca/ <br /> <br />H. Ot~er <br /> <br /> (As required by Building Official) <br /> <br />1 $ ~s 3 5,,o0 <br /> <br /> $35~ <br />__ $60, ~ <br />~$80. <br /> <br /> $300. <br /> <br />~ $ 35,, ,, , <br /> $40. <br /> $80. <br /> <br />~ $ ~5,, <br />~ $ ~0,, <br />__. $ 15, <br /> <br />~ $ 36,, <br /> <br />^~. Enter te~ of tees from Sec, #4 <br />AZ Add 5% sun:ha~e (.05 x A~) <br /> <br /> Sub.mi <br /> <br />B. Enmr ~% ~ line A~ ~r PI~ R~i~ <br /> (~ ~, it ~ui~ A <br />D.C' ~ns~on ~ ¢~.00) ~ <br /> TOTAL A~NT DUE <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />$ <br />$ 1.75 <br />$ 36.7~ <br /> <br />$ 36.75 <br /> <br /> <br />