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FOR OFFICE USE ONLY <br />Received by:~ <br />Date: <br /> <br />MARION COUNTY B~ILDING INSPECTION <br /> <br /> Salem, Oregon 97301 <br /> Phone 588-5147 8:00 am - 4:30pm [2~J <br /> Code-A-Phone: SSS-? O4 SITE #: FEB I 4 1994 Po,m , .o. <br /> FAX; 558-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through <br /> <br />Cross St. <br /> <br />PERMITS ARE NON-TRANSFERABI,R AND NON-RRFUNDABLE AND <br />EXI'IJ4B IF WORK IS NOT STARTED WlTI II~r 1 $0 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDBD FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />tflectrlcal Contractor ?FO e~f{--~m " <br /> <br />SPI'crvJ~°r s Li~x"l'c N°' ],,q 5~¢ I~bone N°'~J <br /> <br />2E, FOR OWNER INST/kLLATIONS <br /> <br />Pa~pcrly Owner <br /> <br />Mailing Ad&ess <br /> <br />Pho~le <br /> <br />City/Smm£Zip <br /> <br />The instakl~ao~ is being made on property I own which ~$ not intended for sale, <br /> <br />3. i'LAN REVIEW SECTION <br /> <br />We will provide phm review service it- you complete Section <br />5B and sttbmit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required sutmfission of lighting power calculations, plans, <br />and Specifications when required by the Oregon Stract~al <br />Specialty Co(lc, Chapter 53. <br /> <br />Date: ibl/m!OH om mvv <br />issu !NG INSPEGIION <br /> <br />4. I~EE SCHEDULE (Complete and enmr total in A l below) <br /> <br /> Number of Inspections per permit allowed <br /> <br />A. <br /> Residential <br /> per <br /> Unit <br /> ScrYJ(~. Included; Jtcms Cost (each) Sum/ <br /> <br /> 1 ~ sq, fl, or less $85.00 ~ <br /> Each ad~a~l 5~ sq, ft. <br /> ~ ~ thereof $15.00 <br /> <br />Dwelling Service or Feeder ~ $40,00 .... 2 <br /> <br /> 201 amps to 400 amps <br /> <br /> 601 amps to I000 amps <br /> <br /> 401 amps to 600 amps <br /> <br /> a) The fe~ for branch cimhit~ with <br /> <br /> h) The fee for branch cimuts ~ <br /> <br /> Bach additional branch cimua <br /> <br />E, Mi~ellaneous (Service or Feeder Not Included) <br /> <br /> above, per h~pecaon <br /> <br /> Pack of i0 labels @ :$5,00 each <br /> (,~old only Id electrical contractors) <br /> <br /> (As r~q~red by Building Official) <br /> <br /> ~50,00 <br /> 60,00 __ 2 <br />$100.00 <br />$130,00 ..... 2 <br />$300,00 .... 2 <br />$40,00 .... <br /> <br />$35.00 __2 <br />$40,00 --2 <br />$80,00 2 <br /> <br />$2.00 <br /> <br />$35.00 <br /> $2,00 <br /> <br />$40.00 _,__2 <br />$40.00 __2 <br /> <br />$40.00 __ 2 <br /> <br />$35.00 <br /> <br />$50,00 <br /> <br />5. FEES <br /> Al. Enmr total of fec~ from Sec. #4 <br /> A2. Add 5% surcharge (,05 x Al) <br /> <br /> Subvolal <br /> <br /> B. Enter 25% of kine A1 for Plan R. cvjew <br /> (Sec, 3). if required <br /> C. InvesagationFee (ff r~q~ired) <br /> D. Reinspeckion Fee <br /> <br /> TOTAL AMOUNT DUE <br /> <br />MC 15.34 11191 l/eeeipt No. <br /> <br /> <br />