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FOR OFFICE USE ONLY <br />I Received by: <br /> Date: ' <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />LOCATION OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> ,JUL 0 1 1992 <br /> Phone 588-5147 8:00 am - 4:30pm <br /> Code-A-Phons: 58g-7904 C~ ~L-- ~- O ~ Permit No, <br /> MARION <br /> <br />PRRMI'I~ ARE NON-TRANSFERABLB AND NON.REFUNDABLB AND <br />EXPIRE IF WORK IS NOT STARTED W1T~IN I gO DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 130 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Cont~cmfs hcmse No. ~ ~ [ [ ~ ~ <br /> <br />Contractor's Board Reg. No. '~.o- O ~. t ) Job No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner <br /> <br />Mailing Address I Phone <br /> <br />City/State/Zip <br /> <br />installation ia being made on property I own which is not inmnded for sale, <br /> <br />3. PLAN R~¥1EW SECTION <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br /> Items "Cost (each) Sum/ <br />Ir, D0 sq. f[. ex le~s ~ $85.00 4 <br />Bach additional 500 sq. ft, <br />or portion thereof $15.00 <br />Lint/md Energy $20.00 ~ i <br /> <br /> Dwelling Service or Feeder ~ $40.00 2 <br /> <br />B. Services or Feeders (Does not inlcude branch c~ rcu~B, see seclion D) <br /> <br /> 50.00 <br />200 amps or lass $~160.00 <br />201 amps to 400 ~anps <br />401 ~wnps to 600 amps $100,00 <br /> <br /> Fi~t branch circuit <br /> Each additional hrallch circuit <br /> <br /> above, per Inspe~on ....... <br /> Pack of 10 labels @ $5.00 each~ $50,00 <br /> <br />5. FEES <br /> Al. Eater Iotal of fee~ fTC~ S~c, 94 <br /> A2. ^dd 5% surcharge (.05 xAI) <br /> <br /> Suhiotal <br /> <br /> B. Enter 25% Of line A 1 for Plan Review <br /> (Se.c, 3). if required <br /> C, ~lvestigationFce (L~ required) <br /> D. Reinspeetlotl Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />, q <br /> <br />MC 15-34 11/91 _, ReceiptNo, <br /> <br /> <br />