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FOR OFFICE USE ONLY i MARION COUNTY BUILDING INSPECTION <br /> <br />Received b: I 220 High Stxeet NE <br /> ...., <br />Date: <br /> <br /> ~i~,,~ . Code-A-Phone: 588.790~ LJ ) SITE #' <br />'" ELECTRICAL PERMIT APPLI~ATi6~H~/ s%"j <br /> P/ease comp/ete al~ Sections, 1 through 5 ~ARION CQUNTY Issued by: <br /> ~UKD~NG iNSPECTiON <br /> <br />L IX}CATION OFINSTALLATION <br /> <br />Jch Address <br /> <br />City <br /> <br />Directions <br /> <br />Cross St. <br /> <br />PERMITS ARE NON-'IRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WlTI-IIN IS0 DAYS OF ISSUANCE <br />OR IF WORK ~S SUSPENDED FOR 180 DAYS, <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />Mailkng Address <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Prol~rty Owner <br />Mailing Address / Phone <br />Gty~ta~p <br /> <br />7he installation is being made on propen~ I own which is ~cg intended for sale~ <br /> <br />Owners Signam~ <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> We will provide plan review service if you complem 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 />MC 15,.34 11/91 <br /> <br />PermitNo, <br /> <br />4, FEE SCHEDULE (Complete and enter total in A1 I~,low) <br /> <br /> Number of Inspections per permit allowed <br /> <br />A, <br /> R~tdential <br /> P~r <br /> Unit <br /> Service [ncluded: Items Cost (each) Sum <br /> <br /> 1000~q~, ft, or l~ss $85,00 <br /> Each aaaitlo~ 5~0 sq. fl, <br /> or pordea thereof $~5,00 -- <br /> Limited ~n~egy $20.00 <br /> ]Such Mana~d ~lora¢ or Modular <br /> Dwelling Se~ic¢ or Fee, der , /' $40,00 ~/t0 - <br /> <br />n Servtces or Feeders (Doe~ not inlcude branch e~rcults, see sectlon D) <br /> <br /> 200 amps or less $50.00 2 <br /> 201 amp~ to 400 romps $60,00 __ 2 <br /> 401 ~nps to 600 amps $100,00 __ 2 <br /> 601 ampslto liX)O amps $130.00 __ 2 <br /> Over 1000 amps or volts $300,00 __ 2 <br /> Re-connect o~ly $40,00 __ <br /> <br />C. Temporary Services/Feeders <br /> <br /> 200 amps or lcss $S5.00 __ <br /> 201 amps to 400 amps $40.00 __ 2 <br /> 401 ~raps to 500 ampS $S0.0O __ 2 <br /> <br /> a)The fe* for bra~ch cltmits with <br /> purchase of serdce or feeder <br /> <br /> Each branch circuit $~,00 <br /> <br /> b)The fee for brtmeh clrcuts without <br /> Imrehase o¢ servin~ or f~od~r <br /> <br /> First branch circuit $3~,00 <br /> Each addiOonal branch ~kcoit $2.00 <br /> <br />E, Miscellaneous (Service or Feeder Not included) <br />~h pump or itrigalion tittle $40.00 __ 2 <br /> Each ~ign or aut~ae l~ghtil~g <br /> Signal clmuk(s) or a limited ealetgy <br /> panel, alteration or extension $40,00 2 <br /> <br /> Over the allowable in any of the <br /> above, per Inspection $g$,00 <br /> <br />G. Minor Installation Labels <br /> Pack e~ 10 tabela @ $5.00 each <br /> <br />H. Other <br /> (As requJred by Building Offi¢i~0 <br /> <br />5. FEES <br />Al-Enter fetal of fees from See. #4 $ ~f~j ~_. <br />A2, Add 5% ~urchavge (.05 x Al) $ ~ <br /> <br /> Subtotal $ <br /> <br /> E. Enter 25% of Uae A 1 for Plan Review <br /> (See, 3), if required $ <br /> C. Inv~t/gatlon Fee (i/required) $ <br /> D, R~hisp¢ction Fee ($25,00) $ <br /> TOTAL AMOUNT DUE $ ~/,~' <br /> Receipt No, . ............... <br /> <br /> <br />