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FOR OFFICE US,E~ONLY <br />Received~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Sn-~et NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 8:00 am. 4:30pm <br /> Cede-A-Phone: 555-7904 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />pERM1TS ARE NON-TRANSI~:RABLE AND NON-P.~FUNDAELE AND <br />EXPIRE IF WORK IS NOT STARTED WITItlN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED POR 180 DAYS. <br /> <br />2A. CONTRA~FOR INSTALLATION ONLY <br />t~leetrical Contractor <br /> <br />[Phone <br /> <br />Mailins Add,ss <br /> <br /> Owner I Phone <br />property <br /> <br />C. ontractofs Board Rcs. No. <br /> <br />Slgnatur~ of Supe~ising Illectficjan <br /> <br />Supucvisor's License No, <br /> <br />2II. FOR OWNER INSTALLATIONS <br /> <br />IJob No, <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide 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 ca/culations, plans, <br /> and specifications when required by the Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br />MC 15-34 ll/91 <br /> <br /> 3ill ~ <br /> <br /> ~ Number of insp~tlons p~ p ' 80 <br /> <br />1~ sq, fi, ~ Iesa $85.00 ~ 4 <br />Each aa&~o~l 5~ S~. k, <br />~~ the~of $15,00 <br /> 1 <br /> <br /> installation, Alterations or Relocation <br /> 200 a,~p~ or I~s~ <br /> 201 amps ;o d~O amp~ <br /> 401 amps to 600 amps __ $100.~0 <br /> 601 amps to 1~00 amg~ $130,00 <br /> Over 1000 amps or volts ~ $300,00 <br /> Rematmeet ~mty $40,00 <br /> <br />C~, Temporary Service, s~eedera <br />lnstatlatlon, Atteratlon, or Retocatlon <br />200 amps or less $35.00 <br /> 40.00 <br /> 201 amps to 400 amps $ $80.00 <br /> 40I arn ato6OOam s <br /> o~ ~ ~rnps o~ 1 ~0 veils <br /> <br />D. 11ranch Circuits <br /> NOW, Xlteratlon~ or Extension Per Panel <br /> <br /> a) Tt'~ fee for b~a~eh clrcui[s with <br /> purehg~e of sor~Acc or feexler fcc <br /> Each branch alrcui[ '~ $9.00 <br /> <br /> b) The fe~ for hrat~ch c/routs <br /> purchase of,service or fe~der fee <br /> <br /> First branch circuit $$5.00 <br /> Each additional branch c~mu~t $2,00 <br /> <br />Ig, Miscellaneous (Service or Feeder N,t Included) <br />Each pump or irrigation circle $40.00 <br />Each sign or outline lighling $40.0e <br />Signal cir~ui£(a) or a limited energy <br />panel, alteration or extension $40.00 <br /> <br />F. Each additional Inspection <br /> over the allowable m any of the <br /> above, per Inspection <br /> <br />G, Minor Installation Labels <br />Pack of 10 labels @ $5.00 each $~0,00 <br />(sold o~dy Io electrical conl~ctors) <br />II. Other <br />( As required by Building Official) <br /> <br />5. FEES <br /> Al. Enter torsi of fees f~om Sec. ~4 <br /> A2. Add 5% sumharge (.05 x Al) <br /> <br /> S~btotal <br /> <br /> B. Enter 25% of ~n¢ A1 for Plan Roview <br /> (S~. 3). if reqttlr~ <br /> <br /> '~TA[. AMOU~ DUE <br /> <br />$ <br />$ to,vt> <br /> <br /> <br />