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FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 Hl'gh SQ-eet NE , <br /> <br /> Phone 588-5147 g:00 am - 4:30pm <br /> Code-A-Phone: 588-7904 Permi% No. <br /> FAX: 588-7948 SiTE 4/ <br /> JUL 0 6 1999 <br /> Date: <br /> <br /> Issued by: MARION COUNTY <br /> BUILDING INSPECTION <br /> <br />LOCATION OF INSTALI.ATiON <br /> <br />PERM1TS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 150 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2IL FOR OWNER INSTALLATIONS <br />property Owoer <br />Mailing Address Phone <br />CJty/StatefZip <br /> <br />l'he nsialla~.on xa being made on i'a~p~tt7 1 own w}dch xs tlo~ mtended for sale, <br />lease, or rent. <br /> <br />OwncF~ Signature <br /> <br />3. 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 appllcatiom <br /> <br />This optional plan review progrtum 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 11/91 <br /> <br />4. FEE SCHEDULE (Complete mxd cmer total in A1 below) <br /> <br />A. Residential Per Unit <br />Service Included: <br /> <br />1000 sq. ~ or less <br />Each additional 500 ~q, ft, <br />or po~on the~of $15.00 <br />Limited Energy'"' ~ $20.00 <br />Each Manu£d Ilome or M~tular <br />Dwe~ng SerVer; ~ Feefle~ .... $~0,00 <br /> <br />III. S~rvlco~ or Feeders (Does not inlcude branch clrcuits, ~ee ~cedon <br /> <br />$85.00 -- 4 <br /> <br /> 1 <br /> <br />--2 <br /> <br /> 20~ amg~ or less ~ $50,00 <br /> 201 amps to 400 amps $60,00 <br /> 401 amps to 600 amps $100.00 <br /> 601 amps to 1000 amps $180.00 <br /> Over 1000 amps or volts .,, $300,00 <br /> Reconnect enly $40,00 <br /> <br /> 200 a~ps or less $35.00 <br /> 201 m~ Io ~ am~ $40.00 <br /> 401 ~ps *o ~0 amps $80.00 <br /> ~er ~0 ~ps or 10~ volts <br /> <br />D, Branch Clrcuita <br /> <br /> Bach brach circuit $2,00 <br /> <br /> b) Thc f~ for branch circuts ~out <br /> purchal¢ ~[ ~c~icc or fe~d~r fcc <br /> <br /> F~t b~nch ciecuit $35,00 <br /> Each additional branch circuit $2.00 <br /> <br />E, Miscellan~us (Service or Feeder Not Included) <br /> ~ch ~mp or imgation circle $40.00 <br /> Each sign or ondine ]ight~g ~ $40,00 <br /> Sigtod ~rcuit(s) or a ~d mc~y <br /> ~n~l, altem~t or extm~[~ $40.~ <br /> <br />E ~ch additional Inspt~t]on <br />over ~e allowable ~ any of ~e <br />a~, ~r ~specfion $B5.00 <br /> <br /> Pack of 10 la~ls (~ $5 00 each $~0.00 <br /> { As ~q~red by Building OfficlaO <br /> <br />5. FEES <br /> <br /> Al. Enter total of fees fxom Sec. #4 $$ ~_ <br /> A2, Add 5% surcharge (.05 x A 1 ) __,, <br /> <br /> SubSoil <br /> <br /> B, Enter ~% of ~ne A1 for Plan Review <br /> (S~. 3), it' ~q~r~ $ .... <br /> C, I~figatim~ 7~ (if mqx~i~e~) <br /> D. Re~s~fim Fee ($25.00) $ <br /> <br /> ~TAL AMOU~ DUE <br /> <br /> Receipt No. <br /> <br /> <br />