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MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE.., <br /> Salem, Oregon 97301 <br /> <br />Phone 588-5147 8:00 ~n - 4:]0pm <br />Code-A-Phone: 588-7904 <br /> FAX: 58S-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />Date: I~AJ~IClN or~l i~,~'v <br />Issued b~.II"DlNtl INSPEC~I0~I <br /> <br />1, LOCATION OFINSTALLATION <br /> <br />o. [c=,s,. <br /> <br />Dimctioos <br /> <br />PEP, MITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF PSSUANCE <br />OR IF WORK IS SUSPENDED FOR I S0 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />IilectrJcai Ccmtractor ] Phone <br />Mailing Address <br /> <br />SJgnatur~ of Supervising Eie~tdcian <br /> <br />26. FOR OWNER INSTALBATIONS <br /> <br />The installation i* I~ing made on property I own which is not intended for sale, <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> We will provide plan review service if you complete Section <br /> 56 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 spec~icadons when required by the Oregon Structural <br />Specialty Code. Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />4. FEE SCHEDULE (Complete and enter total itl Al Dclow) <br /> <br /> Number of Inspections per permit allowed -~ <br />A, <br /> Residential <br /> Per <br /> Unit <br /> ! <br /> Service Included: Items Cost (each) Sum <br /> <br /> 1000 sq. fL or less $Sg.00 4 <br /> <br /> or ~m ~of $15,00 <br /> L~tcd Enemy $20,00 1 <br /> <br />Each Manufd Home or Modular <br />Dwelling Se~Ace or F*eder $40.00 <br /> <br />B. Servk'e,a or Feeders (Does not ~lcude branch circuits, see section <br /> <br /> 2~ am~ or les~ $50,00 <br /> 201 am~ [o 4~ ~p~ $60.00 <br /> ~1 ~ to 6~ raps ~ $100.00 <br /> ~I amps m 1~0 am~ $130,00 <br /> ~er 1~ ~ps or vohs $300.00 <br /> Re,=em rely $40.00 <br /> <br /> 200 amps or less $35.00 <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps $60,00 <br /> dye,r, 600 amps or 1000 volts <br /> <br />D. Branch Circuit~ <br /> <br /> a)Thc fe~ for branch clrcults witZ <br /> g,u~chase of service or <br /> <br /> Each branch circuit $2.00 <br /> <br /> b) ~llte fe~ for branch circuts <br /> rmrchaae of mm(c.e, Dc redder fee <br /> <br /> First branch circuit <br /> Each additinna/branch circuit <br /> <br />E. Miscellaneous (Service or Feeder Not Included) <br /> r~,~ ch pump or irrigation circle $~0,00 <br /> Each sign or outline l!.ghting -- $40,00 <br /> Signal circuit(s) or a limited energy <br /> I~an~l. alteration or extension $40.00 <br /> <br />F. Each additional Inspection <br />over the allowabl~ in any of the <br />above, pet Inspection $~5.00 <br /> <br />G, Minor Installation Labels <br /> Pach of 10 adc s (a} $5 00 each $50,00 <br /> <br />H, Other <br /> ( Aa required by Building OfficLal) <br /> <br />A 1. Enter total of £ccs from Sec. 04 <br />A2. Add 5% surcharge (,05 x Al) <br /> <br /> Subtotal <br /> <br />B. Enter 25%of lineAl for PlanReview <br /> (Sec. S), if rcquire, d <br />C. In'uestigaticmFee (ii te-quited) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />$ <br /> <br /> <br />