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p,~ase com#ete all Sect~ps, l through 5 <br /> <br /> ¢_., <br />MARION COUNTY BUILDING II~LSPECTION :,, ,, :7 <br /> '" 220 High Stre6{ NE ~ - <br /> S. ern, amgen g730 <br /> Phone .588-5147 8:00 am. - 4:30 p,m. <br /> Coda-A-Phone: 588-79o4 SITE #: <br /> <br />iipet~tNo_ <br /> <br />Issued by:: <br /> <br />~ CONIP~C~OR I~'~AU~T~3N ONLY <br /> <br /> 2B. FOR OWNER I'¢STALLA~0NS <br />r Property Owner <br /> <br />City/State/Zip <br /> <br />I The tnatalltelotl Is being made on property I own which is not intended for sale. <br /> Owners Signature <br /> <br />Submit 2 sets of plans with any of the above. <br />Temporan/construction service~ do not apply. <br /> <br />MC ~S:,~ REV,, 7,t~O <br /> <br />Items x Cost = Total <br /> <br />lB. Servloe/Feeclers <br />(~0 ~'ara~ C/n~/~ <br />Installatlon, Altera~orm or Reloc~#on <br /> <br /> 100 amps et less <br /> 101 an~$ to 400 amps <br /> <br /> 601 e. mps to IOOQ amps <br /> Over 10o0 ar~s or volts <br /> Reconnect Only <br /> <br />C, Tempmary ,e_=ervlcoa/Feeders <br /> <br /> 200 ~mps or <br /> 201 amps to 400 amps <br /> 401 amps lo 600 amps <br /> Over 600 amps or 1000 volts (see 4Bi .... <br /> <br />D. IBrenoh Clmults <br />New, Alta/at/cfi or Exlen~/on Pe~ pa/tel <br /> One circuit <br /> Two fo mn <br /> Each add=l ten cltmults or portlo. <br /> <br />E, <br />($e~v/ne Or F~et not/nc/uded) <br /> Each pump or Ir~ation cycle <br /> Eech sign <br /> Signal oircult(s) or a limited ene~ly <br /> panel, alleratJon of extension <br /> <br />F. Each edd*l <br /> OVer the allowable In any of <br /> 1he ~hOVe. per Jn~pec~on <br /> <br />G. Minor th~tallstlon Labels <br /> Peek of 10 labels @ $5o0 each <br /> <br />H. OtJlef <br /> (As r~ulr~d by Building <br /> <br /> 4 <br />$ 15. , ....... <br /> <br />~ $35.__ 2 <br />~ $ 60. ~.~ 2 <br /> <br /> · Sea. 2 <br /> $130. -- 2 <br /> I ~o. 2 <br /> . $ ~ 2 <br /> <br />$3S.~ 2 <br /> <br />A~. Enter total of fees from Sec. #4 <br />A.~. Add 5~. ~s~h~i'~, (.05 x <br /> <br /> '"' Subtetel <br /> <br />B. Enter 25%of lineAl for Plan Review <br /> (Sec. 3), if required <br />C. Investigaaan Fee (if re<~ired) <br />D. Reinspec~on Fee ($25.00) <br /> <br />TOTAL AMOUNT DUE <br /> <br />2 <br /> <br /> <br />