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MARION COUNTY BUILDING INSPECTION <br /> 220 High S~me~ NE <br /> <br /> Phcee 588-5147 8:00 a,m,, - 4.30 pm. <br /> ~hane: 588-7904 SITE #: <br /> FAX: 588-7~48 <br /> Date: <br /> <br /> Permit No, <br /> <br />Issued by: <br /> <br />1, LOCA'I1ON OF INSTALLA3~3N <br /> <br />No. <br /> <br />Signature of Supervising Electrician <br />Supervlsor'a Llcen-e No,, <br /> <br />I Phone No. <br /> <br />2B. FOR OWNER INSTALLA'IIONS <br />Property Owner <br /> <br />Mslllng Address I P~'ne <br /> <br />The Installation Is being made on property I own which Is not Intended for sale. <br /> <br />__ Conne~ed Load over 2(]0 amps (except single family dwellings) <br /> r4uJk~ng system over 200 amps (except sbgle family dwellings) <br /> System over 600 volts <br />__ Building over 2 stories <br />__ Building over 10,000 Square feet <br />__ C~pant load over 300 persons <br />__ Manufactured Dwelling PadVResma~on Pa~rk <br />__ Hazardous L~cations <br /> <br />Submit 3 sets of plans with any of the above. <br />Temporary ~onsn'ucifon services do not apply. <br /> <br />MC 15~4 ReV, 7/'30 <br /> <br />4, FEE SCHEDULE (Complete and enter total in A1 below) <br />Number of In8pe~tlons per permit ettewed ,, <br /> <br />A. Reetdentlel.$1ngleor Item~ X Colt: Total <br /> <br /> Multi.Family per dwelling unit <br /> <br /> lSOOsq, ft, orle~ __ $ SS. 4 <br /> Eeshadd=lSOOsq,,fLerportlon -- $ 15. -- <br /> E~h Mfg/d Home or Modular <br /> <br /> ( l O E, n~r~h Clt~i ts lnduded) <br /> <br /> Recenne~t Only __ <br /> C. Temlx~rmy Servlees/Fesdera <br /> <br /> ;L~01 ampste400amps __ $ 40. __ 2 <br /> <br /> Over 600 amps or 1000 VOltS (Gee 4B) <br /> <br />EacheddltencJrcultsorpor~n __ $ t5. __ 2 <br />(~e~ce or Feeder not included) <br />Each pump er Irrigation cycle ...... $ 36. 2 <br />E~ch sign or outline lighltng __ $ 36 __ 2 <br />Signal elmult(s) or · limited energy <br /> <br /> (8old only tO eles~'ical contmc~or~) <br />H. Other <br /> (As ~Nl~d by ~i~ng Offic/al) <br /> <br />At. Enter tetel of fees from Sec. ~H. <br />A~. Add S% surchame (,,0SxA.~) $ /. ~'..~' <br /> / <br /> Subtotal ~ $ <br /> <br />B. Enter P,.5% ofline A1 for Plan Review <br /> (,Sec. 3). if required <br />C. Iovesl~get~an Fee (if required) <br />D. Reinspec~on Fee ($25,00) <br /> <br />TOTAL ANJ~3UNT DUE <br /> <br /> <br />