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Received by: <br />Oa~e: <br /> <br />ELECTRICAL PERNIT APPLICA'flON <br />P~ase comp/ete a/I Sections, I thr~ 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 2~0 Hi¢3 Street NE <br /> <br /> Phone ,588-5147 81~0 a m, - 4:30 p m. <br /> ~°h°ne:FAX: 588-7948588-7904 SiTE it: I ~,(.,~.~) Permit No, <br /> <br />Mailing Address <br /> <br />Proper~Owner <br /> <br />Supervisor~s License No / ~ 7,,,.~ 5 I Phone <br /> <br />Proper~Owner <br /> <br />Mailing Addto~8 I Phone <br /> <br />Issued by:: <br /> <br />4. FEE ~,CHEDULE (Complete and enter total in A~ below) <br />Number of In~pect~n~ p~r permit eltew~d <br /> <br />Re~onfle~t Only <br /> <br />One eimult <br /> <br />SignaJ eimuit (~) or,~ limited energy <br /> <br />(As required by ~uil~ng Official) <br /> <br />$85, 4 <br /> <br /> $35 <br />__$60, <br /> $80. <br /> $150. <br /> $300 <br /> $35 <br /> <br />__$35. 2 <br />$4o 2 <br />$8o 2 <br /> <br />__$35, 2 <br />$50 2 <br />__$1$, 2 <br /> <br />$;)6 2 <br />$36 2 <br /> <br />$36 2 <br /> <br />PLAN REVIEW 8~ <br /> Check appropna~ item and er1~r <br /> <br />-- Connected Load over 200 amps (except single family dv~i[ings) <br />__, Building system over 200 amps (except sE~gle family dwellings) <br />.... System over 600 vo~ts <br />.... Beil~ng over 2 stories <br />-- B~Jil(~ng over 10,,0(]0 square feet <br />.... Occupant toad over 300 persons <br />__ Manufactured Dwet§ng PanVReca~t~n Park <br />__ Hazardous I..~a~ons <br /> <br />Submit 2 se~s of plans with any of ~e above,, <br />Temporary construction services do not ap~ly <br /> <br />B. Entel 25% of line A1 fo{- Plan Review <br /> (Sec. 3% if required <br />C,, Investigation Fee (if required) <br />D,, Reinspe(~on ~ ($26.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />