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FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1, I~OCATION,OF INSTAL LATION <br /> <br />MARION COUNTY BUILDING INSPEC~N~ r~ ~ <br /> <br /> Phone588-$1478:00atl-4:30pm JUl 0 5 1 <br /> SITE ~' ,-- <br /> <br /> Date .... u i~ ' <br /> SPEOTioN <br /> <br />l~sctiption <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />gXPiRE IF WORK I$ NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 1 g0 DAYS, <br /> <br />2A, CONTRACTOR INSWALLAT[ON ONLY <br /> <br /> · r../lt~antum Electrical <br />g~ancal C~1474 . ~th Ave. N. ~ <br />~alem, O~gon 9~ <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner <br /> <br />Mailing Address ~ Phone <br />City/St ate/~ip <br /> <br />The installation is being made ~a property I own which is no~ int~led for sal~, <br /> <br />Owneffs Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review se~dce if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application, <br /> <br />This optional plan nview program does not suspgnd thc <br />required submission of lighting p~wer calculations, plans, <br />and specifications when required by the Oregon Sm~tural <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br /> issued by: <br /> <br />4, FEE SCHEDULE (Complete and enter total in A 1 below) <br /> <br /> Number ~f inspections per pemit allowed <br /> <br />A. <br /> Residential <br /> Per <br /> Unit <br /> Service Included: Irons Coat (each) gum/ <br /> <br />1000 sq, z, ~ ~¢ less $8~,00 <br />E~ch a~tifioi~1500 ~q. h. <br />or~rpo~rfica thereof $15,00 <br />Limite.~ Ene.~y $20.00 __ <br />Each Manufd ~me or Modular <br />Dwelling gory;cc or Feedex -- $40,00 <br /> <br />B- Services or Feeders (Dc~s not i~loldr branch ~mcits. acc section D) <br /> ~n~ll&Hon, Alterations or Relocation <br /> <br /> 200 amps or less $50,00 <br /> 201 amps to 400 amps $$0.00 <br /> 401 am~ to 600 amps __ $100.00 <br /> 601 amps to 1000 ~mps $130,00 <br /> Over 1000 ~nps or volts $300.00 <br /> Reconnect c~ly $~0.00 <br /> <br />C. Temporary ServlceslFeeder~ <br /> <br /> 200 ampa or leas $55.00 <br /> 201 amps to 400 amps <br /> 401 am ~m600am $80,00 <br /> <br />D. Branch Circuits <br /> <br /> a) The fe~ for branch circuits with <br /> <br /> ~ach brallch (~a~ olt $~.00 <br /> <br /> b)The fee for branch c~:~uza Without <br /> pUrchase of scrvlcc or fead~ <br /> <br /> First branch circuit <br /> Each additional branch ci~uit $2,00 <br /> <br />E. Mlrmeltsneouz (Service or Feeder Not IR¢luded) <br />Each ]pump or itrigatkm cb'de $40.00 <br />Eaah slgn or outline lighting <br />Signal cireuiKs) or a limited energ~ <br />panel, sheraton or exumsion $40.00 <br /> <br />F. F~cb additional Inspection <br />over the allowable in my of tho <br />above, par InspUction $~5.00 <br /> <br />G. Minor lnst~ltstton Labels <br /> Peek of 10 labels @ $5.00 each <br /> (sold only lo electrlea! cord, factors) <br /> <br /> ( A~ req~red by Ruildi~g Off-wis0 <br /> <br />Al. Enter legal of fees from Sue,. #4 <br />AZ. Add 5% surcharge 605 x Al) <br /> <br /> Su~l <br /> <br />B, ~tvr ~% of ~c A 1 ~or H~ Review <br /> ~. 3), ~ ~q~ <br />C, ~v~a~ Fee (d ~ui~) <br />D. R~s~fi~ Fcc ($~) <br /> <br /> ~TAL AMO~ <br /> <br />No, <br /> <br /> <br />