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MARION COUNTY BUILDING INSPECT]ON <br />220 High ~r~-,t NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 8.'00 a.m. ~ 4:30 p.m, <br /> Cede-~-Phone: 588-7904 SITE #_' <br /> FAX: 588-7948 <br /> <br />)~ Issued by: <br /> <br /> ~FEE SCHEDULE (Complem and enter total in At below) <br /> <br />Please c~'~;~e a]l Sec~ons, 1 ~'~ugh 5 <br /> <br />1, I..OQA'nON OF INSTALLAllON <br /> <br />Description:: <br /> <br />Comtaetor'$ Board Rsg, No, <br /> <br />Signature of Supervising Electrician <br />Supervlsor's License No, <br /> <br />2IL FOIR OWNER INSTA LLA'I~ONS <br /> <br />Ne, <br /> <br />I Phone NO, <br /> <br />Proper~ Owner <br />'~l~illng Address <br /> <br />Tho InstaUation Is being made on property I own which is not Intended for sale, <br /> <br />Owner's Si§nature .... <br /> <br />Multi-Family per dwelling unit <br />($erv,~e induded) <br /> <br /> 1500 sq, fl, o~ less <br /> <br /> ~ Mfg,,'d Ho~ or Modu~r <br /> <br />B. ~lc~ers <br /> <br />C, Tem~re~ ~fflee~F~ere <br />~a~ erle~ <br /> <br /> One ¢l~uif <br /> <br /> E~h ~I ~n elmui~ or Pe~n <br /> <br /> Ea=h s~n or outline lighang <br /> Sign~ cl~ult(s) er a limi~ ene~ <br /> <br /> P~k of 10 ~els ~ $~,,~ e~h <br /> <br />$ is. __ <br /> <br />$35,__ 2 <br />__ $ so,, , 2 <br />__$80, 2 <br />$130. ;~ <br />,~=oo. 2 <br />__$35. 2 <br /> <br />$35, 2 <br />__$5o, 2 <br />__$15, 2 <br /> <br />$36. 2 <br />__$36.__ 2 <br /> <br />__$35. <br /> <br />__$50,__ <br /> <br />PLAN REVIEW SEC~ON <br /> Check appropriate item and enter fee in Se~.~ <br /> <br /> . Connected Load over 200 amps (except single family dwellings) <br /> Building system over ;a30 amps (except single family dwellings) <br /> System over 600 volts <br />__ Building over 2 sto~s <br />__ ~uild/ng over 10,00o square feet <br /> Occ~p~ttt load over 300 persons <br />-- Manufactured Dwelling Park/~t~on Pad~ <br /> Hazardous Locations <br /> <br />Submit 2 sets of plans with any of the above_ <br />Temporary constru~on servlce~ do not apply. <br /> <br />Enter total of fees from Se=, ~4 <br />Add 5% surcharge (.05 x A~ <br /> Subtotal <br /> <br />B, Enter 25% of line A1 fo~ Plan Review <br /> (Sec~ 3), if required <br />C. Inves~igmice Fee (if reduimd) <br />D. Reinsper~on Fee ($~5,00) <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />