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FOR OFFICE USE ONLY""'" <br />Received <br />Date: <br /> <br /> MARION COUNTY--BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 $~00 am - 4:30pm <br /> Code-A-l'hon~: 588-7904 <br /> FA:{: SS$-794S SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION Date: <br />Please complete all Sections, I through 5 Issued by: <br /> <br />Permit No, <br /> <br />1. LOCATION OFINSTAI.LATION <br /> <br />"' lob^aa,e** 1988V EASE RD ~ <br /> City AU]R,OI~ [Cross St. M~Y I>,D. NE <br /> <br />nv ~ <br /> <br />PERMITS ARE NON-3I{ANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE II: WORK IS NOT S'I~RTED wrrI41N I80 DAYS OF ISSUANCE <br />OR [F WORK IS SUSPENDED FOR lS0 DAYS. <br /> <br />2A. CONTRACfOR INKrALLATION ONLY <br /> <br />RlectdealCc:atraetor BRI~KS ~g'l~ ~,C. I Phone <br /> 641-0574 <br /> <br />MailingAddress 8059 SW CIRRUS DR. <br />Pmmrty Owner 32~GIE W-iIiqE $ IPh°nc678~2447 <br /> <br /> 34-1§§ CAE <br />Coou~¢~ocs l~oard R~. No. 44421 <br /> <br /> I Job No. 618954 <br />s ~a .r* o~ Sum~sm~ EI~ r e an ,~'. <br /> <br />Supe~i~or% Li~nse No. 592 ~ I Photo No, 641-057~ <br /> <br />2B. FOR OWNER INbTALLATIONS <br />Pm~ny Owner <br />MaJI~lg Address Phone <br />C .y~ a <br /> <br />Thc installaQon is being made on property I own wh/c3 is not intended for sale. <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 gpecificatior~ with <br />this application. <br /> <br />This optkmal plan review program does not suspend thc <br />required submission of lighting power calculations, plans, <br />and specifications wheu required by the Oregon Structural <br />Specialty Code, Chapter 53, <br /> <br />MC/5.34 ]1/9l <br /> <br />4. IeEE SCHEDULE (Complete and enmr ~olal h~ A1 below) <br /> <br />A, Residential Per Unit <br /> Service Included: <br /> <br /> 1000 sq, fl, or les~ <br />Each additional 500 ~q, <br /> <br /> $85.00 ,l 4 <br /> <br /> $15.oo <br />1 $20.00 ~0.0{} <br /> <br />~ach Manu£d Ilcnne or Modular <br /> Dwelling Se~ce or Feeder <br /> <br />$40,00 <br /> <br /> 201 amps to 400 amps <br /> 401 amp~ to 600 amps <br /> 601 amps to l(~.10 amps <br /> Over 1000 amps or vol~s <br /> Reconnect only <br /> <br /> 200 amps or less <br /> 20I amps to 400 amps <br /> 401 ~rnps to 600 ami~s <br /> Over 600 amps et 1000 volts <br /> <br />D, Branch Circuit~ <br /> <br /> a) The fee t'ot branch drcuits with <br /> purchase of s~rvice or feeder ~)q <br /> <br /> Laeh branch clrcuii <br /> <br /> b) The fee for branch drcuts ~ <br /> ~>g{rchas¢ of service Or feeder fee <br /> <br /> Each addifonal branch circuit <br /> <br /> Each pump or irrigation circle <br /> Each sign Of outhnc llgh0ng <br /> Signal circuit(s) or a limited energy <br /> <br />F. Each addltto,al Inspection <br /> <br />G. Minor Installation Labels <br /> Pack o[ lO labela ~ $5.00 each <br /> (sOld only to electrical contractor.*) <br /> <br />ti. Other <br /> (As r~quired by lhdlaing Officio0 <br /> <br />50,00 __2 <br />60.00 __ 2 <br />$100,00 __ 2 <br />$130.00 2 <br />$300.00 2 <br />$40.00 2 <br /> <br />$85.00 2 <br />$40.00 --2 <br />$80.00 2 <br /> <br />$2.00 <br /> <br />$85.00 <br /> $2.00 <br /> <br />$40.00 ..... 2 <br />$40.00 --2 <br /> <br />$40,00 2 <br /> <br />$35.00 <br /> <br />$~.00 .... <br /> <br />5. FEES <br /> <br /> Al. Enter total of i%cS from Sec. #4 <br /> A2. Add 5% ~utcharge (,05 x Al) <br /> <br /> Subtotal <br /> <br /> B, Enter25%ofhneA1 for Plan Review <br /> (S~z. 3), i f req~r~ <br /> C. Inv~stigaaon Fee (if rmlulrod) <br /> D. Relnspec0cnt Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> Receipt ~o ...... <br /> <br />~20. O0 <br />$ <br /> <br /> 21.00 <br />$ <br /> <br /> <br />