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BUILDING INSPECTION <br /> FOR OIWiCE USE ONLY <br /> Received I)*,' 220 High Street NE ~ ~ ~ ~,~ <br /> <br /> Phone 588-5147 8:~ ~- 4:3~m <br /> <br />~ ELECTRICAL PERMIT APPLICATION ~ Date: MARION COUNTY <br /> Please complete all Section& though 5 Issued ~,~n~ <br /> <br />][, LOCATION OF INSTALLATION <br /> <br /> 'l <br /> <br />PERMITS ARIf NON -ql~.AN SFERABLE AND NON-REFUNDABLE AND <br />IiXPIRI'; IF WORK iS NOT $1ARTED WITIIIN 180 DAYS OF ISSUANCE <br />OR II; WORK I$ SUSPENDED FOR 1 S0 DAYS. <br /> <br />FOR OWNER INSTALLP~['ION$ <br /> <br />3. PI.AN REVIEW SECTION <br /> <br />We will provide phm review service if you complete Section <br />5B and snbmit two (2) sets of plans and specifictitions with <br />this applicatlon, <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />aed spcxzificadons when required by the Oregon Structural <br />Speci::!ty Csxlc, Chapter 53. <br /> <br />4, FEE SCHEDULE (Complete mad enter total i~l A 1 below) <br /> <br /> sRI ! I ide ntiallugerdUnitervcelnc de:Number of {nsp~tions~,Pe~ permit allowed <br />A. <br /> Itern~ Cost (each) <br /> <br />Bach ManuFd Home or Modular <br /> Dwelling Servic~ or Feeder <br /> <br /> $40.00 <br /> <br />Services or Feeders (Does not mlcudc branch circtdts, see section <br /> <br /> Installation, <br /> Alterations <br /> 200 amps ~ l~ssor $$60,00 <br /> 401 amp5 to 600 amps $100.00 <br /> 601 amps to 1000 amp$ ~ $130.00 <br /> Over 1000 amps or volts $800.00 <br /> Reccmneet ~,ly ~ $40 .OO <br /> <br />C, Temporary $ervieedl~eeders <br /> <br /> 200 amps or lesa $35,00 <br /> 201 antps ~0 400 amps $40,00 <br /> <br />D, Branch Circuits <br /> <br /> pureha~e Qf,~rvice or leader <br /> Each breach circuit $2.00 <br /> b) The fee for brai~¢h clrclas <br /> <br /> Fimt branch ej¢¢ttit ~ <br /> Each additional branch clrc~t $2,00 <br /> <br />E, Miscellaneous (Service or Feeder Not Included) <br /> Each p~p or irrigation circle $40.00 <br /> <br /> panel, alteratical or extension $40 <br /> <br />5. FEES <br /> Al. Eater total of fees from Sec. ]14 <br /> A2. Add 5% surcharge (,0S x Al) <br /> <br /> Subtotal <br /> <br /> B. Enter 25%oflinuAl for Plan Review <br /> (Sex~, 3), if required <br /> C- ~[avestigationFee (it' requited) <br /> 'D. Reinspection Fcc ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />5,2.50, <br /> <br />MC 1fi-34 ]l/9l F. eceiFt No. <br /> <br /> <br />