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MARION CO~Y~BUILDING INSPECTION <br /> 220 High S~ect NE <br /> Salem, Oregon97301 <br /> <br /> Pho~588-5147 8:00am-4:30pm <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br /> 1- LO~ATION OF INSTALLATION tsst BIki~ <br /> ,°,Add.,, // <br /> <br />I <br /> <br />pERMITS ARE NON-'iRANSFERABLE AND NON-REFI. U~DABLE AXD <br />EXPIRE IF WORK IS NOT STARTED W1TIIIN ! 80 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED POI{ 1 ~0 DAYS. <br /> <br />FOR OW~IER INSTALLATIONS <br /> <br />PrOl'~f~J Owner <br />Mai~ng Address Phone <br />Ci[y]~tatcffjp <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Tha imtaliatlon is b6ing made on pn;~eny I own which is nog ~temded for sale, <br /> <br />Issued by: <br /> <br />Permit No, <br /> <br />$ <br />$, <br />$ <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 />MC 15-34 1l/9,1 <br /> <br />Owners Signature <br /> <br /> IllI ....... I <br /> <br /> PLAN REVIEW 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 />5. FEES <br /> <br /> AY, Add 5% surchalge (,05 x Al) <br /> <br /> (See. 3), if required <br /> C. hwesfigation Fee (if ~qui~d) <br /> D, Reinspectlo~ l~ee ($25,00) <br /> <br /> Receip[ No. , . <br /> <br /> Inalalhitton, Alt~atlons or Relocation <br /> 200 amps or less $50,00 <br /> 20t amps to 4~0 amps $60.00 2 <br /> 401 amps to 600 ~mps $100.00 2 <br /> 601 amps to I000 amps $~30.00 2 <br /> Over 1000 amps or volts ~ $300.00 ..... 2 <br /> Reconnect only $40.00 __ 2 <br /> <br />C. Temporary Services/Feeders <br /> <br /> 200 amps orless $35.00 ~ 2 <br /> 2fR araps to 400 amps $40,00 ~ 2 <br /> 401 amps to 600/amps $80,00 <br /> Ore?00 amps or I000 volls <br /> <br />D. Branch Circuits <br /> New, Alteration, or E~enshm Per Panel <br /> <br /> a) The re* for branch circaita ~ <br /> purchase 9~ serif/ce or feeder fqe' <br /> Each branch ekeua $2,00 <br /> b) The fee- for b~aneh eireuts ~ <br /> <br /> Elm br~n~h elreult $85,00 <br /> ~ additional branch eixeuit ~ $~,00 <br /> <br />E. Mtac~llaneo#$ (Service or ~eeder Not Included) <br />Each p~mp or irrigation c/tale $40.00 __ 2 <br />Each sign o~' olfl/-ne lighting $40.00 <br />S~gnaJ el,cna(s) or a llmitcd <br /> pane. l, alteration or cxte~lsion ~ $40,00 2 <br /> <br />F. Each additional Inspeenon <br />over the ~owabl¢/n any of the <br />above, per Inspection $35.00 <br /> <br />G. Minor Installation Labels <br /> Pack of i0 labels @ $5,00 each <br /> (soM only to el~ctrlcal ¢ontraetom) <br /> <br />H. Other <br /> (As re¢,,;red by Building Official) <br /> <br />~' q.~l~ SCHEDULE (Complctc and *n~r ~1 ~ A1 ~low) <br /> <br /> Numar ~ Insp~tl~ p~ pemlt allow~ <br /> <br /> A. <br /> R~ldenflal <br /> Per <br /> Unit <br /> 1 <br /> 5e~ice Inclu~l items Cost (ca~) <br /> 1~ sq, ~ ~ less $85.00 4 <br /> <br /> ~ffi~ tbem~ $15,00 <br /> L~ E~y ~ $20.00 <br /> ~h Manufd H~e or M~r <br /> Dwe~ng Se~ ~ Feedm ~ $40.00 ~' ~ 2 <br /> B. Servl~ or Feedors ~s not ~lcude branoh d mults, see secfi~ D) <br /> <br /> <br />