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FOR OFFICE 'USE 8NLY <br />Receive.d by: I <br />Date: <br /> <br />MARION COUNTY BUILDING iNSPECTION <br /> 220 High Street NE ~r~ <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 S:00 am - 4:30pta <br /> Coda-A-Phone: 588-7904 <br /> FAX: 588-794S SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION I <br />P/ease complete all Sections, I through 5. I <br /> <br />Permit No, <br /> <br />Date: <br /> <br />Issued by: <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMYI'S ARE NON-'IRANSFERABLE AND NON-R~FUNDABLE AND <br />EX2~ E IF WORK IS NOT STARTED WITI tin 1 S0 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2B. FOR OWNER INfrfALLATIONS <br /> <br />Property Owner <br /> <br />Mailing Addr~as Phone <br />CJty/Stata/Zip <br /> <br />3, PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />511 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 Cede, Chapter 53. <br /> <br />MC 15.34 11/91 <br /> <br />4. FEE SCHEDULE (Complete and eater total in A1 below) <br /> <br /> Number of Inspections per pemlt allowed <br /> <br />A. <br /> Resldential <br /> Per <br /> Unit <br /> / <br /> Service Included: It~ns Cost (each) Stem <br /> <br /> 1000 s~.I. ft. or less $85.00 <br /> 4 <br /> Each a&~itiona1500 sq, <br /> o~ po~do~ thereof $16.00 <br /> Lhnited ~nelXy $20,00 -- 1 <br /> Ea~ Manu£dHomc or Modular <br /> Dwelling Semi~ or Feeder $40.00 __ 2 <br /> <br />B, Servio~ or Feeders (Does not inlcude branch circuits, sca section D/ <br /> Installation, Aaeeatlons or Relocation / <br /> 200 amps or less 50 00 <br /> 201 m-np~ to400 mmps ' ~60:OO q~ ~/.'22 <br /> 401 romps 1o 600 amps $100.00 2 <br /> 601amlps]s m 1000 amps $130.00 -- 2 <br /> O~r 1000 amps or volts $300,00 -- 2 <br /> R.~connact mly $40,00 __ 2 <br /> <br />C, Temporary Services/Feeders <br />Installation, Alteration, or ReloeaSon <br />200 ~rnps or lass $$$,00 __ 2 <br />201 amps to 400 amps $40,00 __ 2 <br />401 amrnpss to 600 amps $80,00 __ 2 <br />Over 600 amps or 10gO volts <br /> <br />D, Branch Circuits <br /> <br /> a) The fgn for branch c/rcults with <br /> Each branch clmuit G $2,00 <br /> b) Thc fee for branch drcuts without <br /> <br /> Each pump or in/gatlc~ circle $40,00 -- 2 <br /> Each sigm or outline Eght~g __ $40.00 2 <br /> <br /> Pack of 10 labels @ $S.00 each $$0.00 <br /> (sold onl? to electrical comractor*) <br /> <br /> ( As reqltired by Bailding Offi¢ia0 <br /> <br />5. FEES <br /> Al- Enter total of fee~ from Sec, #4 <br /> A2. Add 5% surcharge 605 x A 1) <br /> <br /> Subtotal <br /> <br /> g. Enter 23% of m~ A1 for Plan Review <br /> (Sec. 3). if ~quized <br /> C. InvestlgationPee (ff required) <br /> D. ReJnsp~aon Fee <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Receipt No. <br /> <br /> <br />