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Received by: <br /> <br /> P,~ase comp/ete a//Sect/oas, I t/~ 5 <br /> <br />MARION COUN1'~ BUILDING INSPECTION <br /> 220 High ~ NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 58~5147 8.'0o a_m - 4~J0 p.m,, <br /> Coda-A-Ph0~e: 58~-7~0~ SITE #: <br /> .... FAX:: .588-794a Dato: <br /> <br /> Issued by: <br /> <br /> FOR OWNER elSTALLA'I'f~ <br />Proper~ Owner <br /> <br />The Irlstall&tlon is being made on property t own which is no! intended for aale. <br /> <br />Permit No,, <br /> <br /> FEE SCHEDULE (Gomplete and enmr total in A~ below) <br />($ervice tnduded) <br /> <br /> 0 ~ ~ ~) <br /> <br /> l~a~or~ <br /> 101~sto~ <br /> <br /> ~0 a~ Or le~ ~ $ ~. <br /> <br />~$eo~ <br />-. $80,__ <br />-- $130. <br /> <br /> $ 35,, ~ <br /> <br />D. Branch CIr~ulte <br />New, AiZeralfon o~ Ex~nsio~ Per P~el <br />Two=mnd~i~ ~ $ ~,, ~ <br />E~h~d'l~ncl~ui~orpo~n ~ $15 .. <br /> <br /> E~h pu~ ~ Ifdga~n ~=le ~ $ ~ ~ <br /> S~n~ simult(s) or a fl~ enemy <br /> <br /> ~ the ~l~e In any ~ <br /> P~k of 10 I~ ~ $5,~ ~h $ ~. <br /> <br />3. PLAN REVIEW SECT]ON <br /> C. heck ~iate ~m and enter ~,e in ~ 5S, <br /> <br />__ Conneoted Load over ~ amps (except single family dwellings) <br />.. Building system owr 200 amps (except s~ngle [~u'nily dwe~tings) <br />_., System over 600 vo~s <br />_, Building over 2 stories <br /> <br />__ Occupant Io<'~1 over 300 persons <br />__ Manu/a~tured Dwelling Patk/IRe~atlOn Pan~ <br /> <br /> · Hazardous Locations <br /> <br />Submit 2 sets of plans with any of the above, <br />Temporary ce~s~uc~on ser~bes do not apply. <br /> <br />Enter total of fees from Se~, ~, $, <br />Add 5% surcha~e (,,0~ x At) $. <br /> <br /> Subtetel $. <br /> <br />B, Enter 25%oflirmA~ for Plan Review <br />(Sec, 3), if required $ .... <br />C,, Invesllgali~n Fee (if reQuimcl) $ <br />D, Rsinspection Fee ($2500) $ <br /> <br /> TOTAL AMC)UNT DUE $ <br /> <br /> <br />