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OPRCE4.~ ONLY <br />Received by: <br />Date: <br /> <br /> ELECTRICAL PERMrI' APPUCATION <br /> Pease comp/ets a//Sect/om, 1 through 5 <br /> <br />1. LOCATION OF INSTAU.A'I~3N <br /> <br /> obAddtess 14633 OTTAWAY <br /> ~iU AURORA, <br /> ~re~gon~: 1 block east of Hw¥ 99 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 2~0 High Street NE '~" ';'~ ~'~ <br /> Salem, Oregon <br /> Phoee 588-5147 s,~)O ~.rc. ~ 4~o p.rc, <br /> <br /> i FAX: .5$8-'/948 ' O at~: MA~IOI',I P~!..Ib!Ty <br /> , IUILDIN6 IN, PE, CYt0N <br /> <br />Oescrlpllon:, ...... ,Install 1 wall sign <br /> on <br /> <br />~i'eGt ricaJ Contractor <br /> Heath Signs <br />Ma,in~Addre~ 4644 $.E. 17th Ave <br />Prope~ Owner <br /> Gall Smets <br /> <br /> 37-45 C <br />0ontrastor's Boa~d Reg. No, 64263 I Job NO. <br /> 43316 <br />SI9~ ~.)~ ,e 9 ~,~ ujlywIsin9 Electrician <br /> <br />Supervisor's LIc~l~se No. <br /> 413 SI I PhoneNo,, 232-2620 <br /> <br />2B. FOR OWNER t~ISTALLATIONS <br />Property Owner ' <br />i~1;, Illng Address <br /> <br />The installation is being made on property ] own which is not intended ret sale, <br /> <br />%, ~LNA R%'~N <br /> Check applRoriate item and e~ar fee in Se=b'on <br /> <br /> Conner--ted L~ad over 200 amps (ex¢ept single family dwellings) <br /> . Building system over 200 amps (ex~ept s/ngle family dwellings) <br /> Systerc OVer 600 volts <br /> __ I~uilding over 2 <br /> .. Building over 10,000 ~:luam feet <br /> Occupallt k~ad over 300 per~ons <br /> Manufactured Dwelling PaddRecma~n Par~ <br />~ Hazardous Locations <br /> <br /> Submit 3 sets of plans with any of the above. <br /> Tercpor~y con$1~on s<~'vic~ ~o not apply, <br /> <br />4. FEE SCHEDULE (Complete and enter total in A? below) <br />Nurcber of Inspections per permit eltawed <br /> <br />A. Residential, Single or IA, ma x Coat = Total <br /> <br /> Eachadd'lS00sq, ft, orportlon ~ $ 15, .- <br /> Each M fg,'d Home or Modular <br /> <br />lB. ~ervlee/Feedere <br /> <br /> 100 amps or less -- $ <br /> 101 an'~sta 400 an'~s -- $ ~0..-- <br /> 401arnpslo6ooamps ~ $ 80, <br /> <br /> ReCCilneclOnly -- $ 35. <br /> ZOO amps or le~ $ <br /> <br /> Over 600 amps or 1000 volts (See 40) <br /> <br /> Two ta tan dtcuits __ $ SO. <br /> <br /> Eash pump o~ Irr;gation cycle <br /> Each slgil er outline lighting <br /> Signal circuit(e) or a limited energy <br /> <br />Pa=k of 10 labels @ $5,00 ea~h $ SQ. , <br />(Sold on~y to e/ec~'ical conkacto~) <br />H. Other <br />(As required by B~#ding <br /> <br /> $36, 2 <br />--ETT' $ :~. -~. oo ~ <br /> <br />~ $36. ~ 2 <br /> <br />Al, Enter tatal of fees from See, <br />A2, Add 5% sm'charge 605 x A~) <br /> <br /> Subtotal <br /> <br />lB. Enter 2,5%oflineA1 for Plan Ftaview <br /> (Sec, 3), if required <br />C,. Inves~ga~o~ Fee (if m~ulmd) <br />D. Reinspe~ion Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Recent No. <br /> <br />$ <br /> <br />$ <br /> <br />$ 42.00 <br /> <br /> <br />