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IFOR OFFICE USE ONLY <br /> Received by: <br /> Date: ' <br /> <br /> MARION COUNTY BUILDING INSPF~TION <br /> <br /> Phono555-51478:00m-4;30pmcode_A_Pho~:58S.7~4 ~P ~ 7 199 it o. <br /> ~: 5~8-794~ SITE ~: <br />ELECTRICAL PERMIT APPLICATION I Date: MARION COUNI'Y, <br />Please complete afl Sections, I through 5~ BUILDING INSPECTION <br /> ...... Issued by: <br /> <br />L LOCATION OF INIETALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTLED WITI.I1N 180 DAYS OF ISSUANCIE <br />OR IF WORK IS SUSPF~/DLED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />C~,ractoeslJc~seNo, ~q-lOq c <br /> <br />2B. FOR OWNF, R iNSTALLATIONS <br />P~Ol~rty Owllcr <br />Mail,s Address Phon~ <br />City/State/Zip <br /> <br />3, PLAN REVIEW $FA2TION <br /> <br />We will provide plan re'dew 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 />4, FEE SCHEDULE (Comple[e and enter total M A 1 below) <br /> <br /> Number of Inspections pet permit allowed <br /> <br />A. <br /> Residential <br /> Per <br /> Unit <br /> Service I.cluded: items Coat (each) Sum/ <br /> <br />I000 sq, fl, or les~ $85.00 <br />LEach additional 500 sq, <br />or FOtti~n thereof __ $15,00 <br />Limited Energy $20,00 __ <br />Each Manuf'd 14omc or Modular <br /> <br /> Dwelling Se. rdce or Feed~ $40.00 2 <br /> <br />Ins~llation~ Alterations or Rel~atlon <br />~ am~ or les~ / $50.00 ~ ~ <br /> <br /> 201 am~ to 4~ ~ps <br /> ~1 ~ps to 6~ ~ps ~ $100,~ 2 <br /> <br />Re~ect rely $40.00 2 <br />Temporary 8erviee~'~ders <br /> <br />2~ ~ps or Iess $35.00 ~ 2 <br />20t ~p~ ~ ~0 amps $~.00 2 <br />401 ~ps to ~ am~ $80.00 ~ 2 <br />~er ~0 ~ps or 10ffi volts <br /> <br />D, Branch Circuits <br /> <br /> a) The fee for br~mch c~reuit_q gL~J <br /> <br /> Each sign or outline .il. sbt,MS <br /> <br /> (Aa mq~dred by Buildbag Official) <br /> <br />$2,00 <br /> <br />$$&O0 <br /> $2.00 <br /> <br />$40.00 <br />$40.00 <br /> <br />$40,00 ~2 <br /> <br />$35.00 <br /> <br />$50.00 ~ <br /> <br />5. FEES <br /> Al, Enter total of fees from Sec. #4 <br /> A2, Add 5% surcharg~ (.OS x A1) <br /> <br /> B. Enter 25% of lineAl for P'lanRevlew <br /> (Sec, 3). if required <br /> C, InvestlgationFec (if requited) <br /> D. R¢inspect{on Fcc ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />MC 15.34 11/91 P,~,¢~ip No. <br /> <br /> <br />