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MARION COUNTY BUILDING INSPECTION <br /> 220 Hic, h SIx~ct NE ~ 1.,'~,"~,,9 x~.'~'~ ..... <br /> ELECTRICAL PERMIT A~PLICATION I Date: <br /> <br />Cross ~ <br /> <br />MARION, <br />BU~LRING I <br /> <br />PERMY~ ARE NON-TRANSfeRABLE AND NON-REFUNDABL~ AND <br />EXPIRE IP WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS $ USP,~'-~ED laOR I SO DAYS. <br /> <br />9A. CONTRACTOR INSTALLATION ONLY <br /> <br />CoatractofsBoardP~g. No, ~ ~OO~1 I {IohNo, <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Prop~zW Owner <br /> <br />Ck¥~a~/Zip <br /> <br />T~e bs~al]a~ioo is ~ins maSe on prol~ny I own w~i~ is noi in~n~M for sal~, <br /> <br />Owner's Signature ...... <br /> <br />3. PLAN RI~VIEW $1~CTION <br /> <br /> We will provide plan review s~rvicc if you comple~ Section <br /> fib and submit two (2) seIS of plans and specifications with <br /> this application. <br /> <br /> This optional plan rgview program does not $uq~ond the <br /> required submission of lighting power calculations, plans, <br /> and specificaQons when required by the Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br />MC 75-34 H/97 <br /> <br /> Numar ~ Inactions p~ pemlt allow~ ~ <br />A. <br /> ~r <br /> Unit <br /> ] <br /> S~I~ Ifl¢loded~ It--s C~t (~h) ~/ <br /> <br /> ~ ~ ~e~ ~ $16,00 <br /> ~ Se~ ~ F~d~ ~ $~.00 ~ 2 <br /> <br /> 200 ~mp~ or l~ss ,.. <br /> 201 amps to 400 am~ .. <br /> 401 amps w <br /> ~1 am~ m <br /> <br />C. T~r~ry <br /> <br /> 401 ~ps to <br /> ~er ~ ~ps or 1~ vol~ <br /> <br /> Each ~&~ b~h g~c~t _ <br /> <br /> ~er ~e ~owab~ <br /> <br /> P~k of 10 la~s ~ $5.~ ea~ <br /> <br />H, Other <br /> ( A~ ~e~red by B~din$ <br /> <br />5. FEES <br /> Al, ~t ~al elf. s f~m S~. ~4 <br /> A2. Add 5% su~ha~ (.05 ~ Al) <br /> <br /> (S~. 3), if <br /> C, ~V~g~ F~ (ff~qu~d) <br /> <br /> ~TAL AMO~ DUE <br /> <br /> ~50,00 <br />$100.00 <br />$130.00 <br />$300.00 <br />$40.00 <br /> <br />1 35,00 2 <br />40.00 2 <br />80,00 2 <br /> <br />$2.00 <br /> <br />$2,oo <br /> <br />$40.00 <br />$40.00 <br /> <br />$40,00 <br /> <br />$35.00 <br />$50,00 <br /> <br />$35',00 <br /> <br />$ <br /> <br /> <br />