Laserfiche WebLink
] ~FOR. OFFICE USE ONLY <br />[ Recetved by:. . <br />i, oa!e: _ , <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Sffeet NE <br /> Salem, Oregon 97301 <br /> <br /> Phonc 588-5147 8:00 ~a - 4:30pm <br /> Code-A-Phoae: 588-7904 <br /> FAX: 5118.7948 <br /> <br />IELECTRICAL PERMITAPPLICATION <br />P/ease complete ail Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />ExI>nlE IF WORK IS NOT STARTED WITHIN 150 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 1 SO DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />El~ctdml Centmctor ,{. Phone <br />Mailing Address <br /> <br />$1gnatum of SuI~rVlslng ~ectridan <br /> <br />Sup~isoFs I~ccnsc No- { Phonu No., <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />~c instalh~n is ~J.g made ~ ~y I own wM~ is na ~nded for sale. <br />3. ~N RENEW S~ION <br /> <br />Wc will proyide plan review 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 Stmctmal <br /> Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />Date: <br /> <br />z40 Goof <br /> <br /> Issued by: <br /> <br />4, FEE SCHEDULE (Complet* ~md enter mia] in A1 bdow) <br /> <br /> Number of Inspections p~ pemit allowed ~ <br />A. <br /> Residentl{I <br /> Per <br /> Unit <br /> 1 <br /> Service Included: It.s Cc~*t (each) Sum/ <br /> <br /> E~ ~ 5~ sq, ~ <br /> ~ ~ thief $15.00 <br /> <br /> ~ng S~ or Fe~ $40.00 ~ 2 <br /> <br /> ~ ~ps mless ~ ~60.00 ~ 2 <br /> ~1 ~ m 4~ amps $60,00 2 <br /> ~1 ~ps ~ ~ ~ps $100,~ -- 2 <br /> <br /> ~ 1~ ~p~ or volt~ $~0.00 2 <br /> ~t ml~ $40,00 2 <br /> <br /> C. Teml~rary Servlcez/Feeder~ <br /> Installation, Alteration, or Relocation <br /> 200 m'nps or less <br /> 201 ~ps to 4~ ~ <br /> 401 ~p~ to <br /> ~er ~ amps or 1~ volts <br /> <br /> D. Branch Cimut~ <br /> New~ Al~a~on~ or ~xtenMon Per Panel <br /> <br /> a) ~e f~ for <br /> pamhase <br /> <br /> ~a~ b~ch c~uit <br /> <br /> ~ b) ~ f~ f~ ~ch d~t~ ~tbgpt '~ Or f~der fee <br /> <br /> F~t bmn~ <br /> Each M~fion~ brach ~m~t <br /> <br />~ Ml~ellan~us ~rvlce or Feeder Not Included) <br /> <br /> ~ si~ or ~ffina l~h~g ' <br /> <br /> ~eI, almra~ ~ ~tmslm <br /> <br />F. Each additional Insp~tion ~er <br /> <br />G. MInoe Installation La~ls <br /> <br /> (sold o~y to electrical co.factors) <br /> <br />H. <br /> (as ~q~a Oy ~ita~g Officio <br /> <br />5. FEES <br /> Al, ~nter total of fees from Sec. #4 <br /> A2. Add 5% sarcharg¢ (.05 x Al) <br /> <br /> Subtotal <br /> <br /> B, g-dt.L--r.25% of lln¢ A 1 for Plan Review <br /> ..... (_Scc~ 3~, ff..mqulred <br /> C. Investigatid'n,Fee (ffrcquimd) <br /> D, Reinsp~ction <br /> <br />$35.00 __2 <br />$40.00 __2 <br />$80.00 <br /> <br /> $2.00 ~' ' <br /> <br />$35.00 <br /> $2,00 <br /> <br />$40.00 __2 <br />$40.00 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br /> $ <br /> $ <br /> $ <br /> <br />t No. <br /> <br /> <br />