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FOR. OFFICE USE oNLY I' <br />Received by: <br />Date: ' <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through <br /> <br />MARION COUNTY BUII~.DING INSPF.~TI~ <br />S~m, ~n 97301 ~ _ ~ <br /> <br /> ~-A-~: S88-7~4 SITE ~: ,, ' <br /> F~-7~8 <br /> <br />L LOCATION OFINSTALLATION <br /> <br /> Cross SL · <br />Dimctlc~ j j/ ...... <br /> <br />pERMTrS ARE NON-'IRANSFERABLE AND NON.REFUNDAB I..E AND <br />EXPIRE IF WORK IS NOIr STARTED WITHIN 180 DAYS OF ISSUA~CB <br />OR IF WORK IS SUSPENDED FOP. 180 DAYS, <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />P'x, psay Owner <br /> <br />Maili~g Address I Phone <br /> <br />City/State/Zip <br /> <br />The:thstallatlcm is being mad~ ~m pwp~ny I own which is nd intendM for sale, <br /> <br />Owner's Signature .... <br /> <br /> PLAN REVIEW SPJ%'TION <br /> <br /> We will provide plan review service if you Complete Section <br /> 513 and submit two (2) sets of plans and specificafigns with <br /> this application. <br /> <br /> This optional plan review pm~'am does not suspend the <br /> required submission of lighting power calcalationsi plans, <br /> and specifications when required by the Oregon Structmal <br /> Specialty Code, Chapter 53. <br /> <br />MC 15-34 ll/91 <br /> <br /> D . MARION Cdt~,~, <br /> <br />~q {l FElg SCHEDULE (Compl~t: =d rater tot~Iin A1 ~w) ~ <br /> A. R~iden0al Per ~nit <br /> Semite Include: It--s C~t (e~h) ~/ <br /> <br /> $~.oo 4 <br /> 1~ sq. fL ~less <br /> <br />Bach Maont'd Home or Moduht <br />Dwellin8 Set~ig or Faedex $40,00 __ $ <br /> <br /> Scrvl~ or Feeders ~s aa Ml~de ~nch dmuiB, see s~fi~ D) <br /> <br /> 2~ am~ ~ ~ss ~ $ ~,00 2 <br /> 201 ~ to 4~ ~ps ~ 2 <br /> $~oo.~ 2 <br /> <br /> $~0.~ 2 <br /> $40.00 ~ 2 <br /> <br /> 401 amps to 600 amps <br /> 601 amps to 10OO amps <br /> Over 1000 aanps orvol~ <br /> Reconnect ~ly <br /> <br />C. Temporary Servlcea/Feedffs <br /> Installation, ARcration, or RdocaUon <br /> $.00 <br /> :ZOO amps or le~s ...... <br /> 201 amps to 400 amps <br /> 401 am ~ to 600 am ~ $80.00 <br /> Over ~ amps or 1~00 volts <br /> <br />D- Branch ClrcuRs <br /> N~w, Alteration, or Extensinn Per Panel <br /> <br /> a)Th* f~ for bran& circuits with <br /> purchase of sa~i~ or fe~der <br /> <br /> ]Each branch oirouit ~ $2,00 <br /> <br /> b)TEa fcc for branch dinars wi~out <br /> purchase of service or fe~der <br /> <br /> F~rst branch ~muit <br /> Each additional branch circuit ~L~ SZ.O0 <br /> <br />g. Migeellaneous (Service or Fee~er Not InclUded) <br />Each l~mp cc in~gafic~ dfc, lc $40,00 <br />Each sign or out. Line lighting <br />Signal circuit(s) or a limited <br />panel, alteration or ext~sion $40.00 <br /> <br />F. Each additional <br />~vet the allowabl~ in any of th~ <br />slow, ~r laal>eo~Otl $85,00 <br /> <br />G, Mthor Installation Lal~ls <br />Pack of 10 labels @ $.5.00 each .... $.50,00 <br />(sold only to electrieM contractors) <br /> <br />It. OOatr <br /> (As reqtdred by Building Offlda0 <br /> <br />5. FEES <br /> Al. Enter total of fees from $~¢, #4 <br /> AZ, Add 5% sur~haqga (,05 x A1 ) <br /> <br /> Subtotal <br /> <br /> B, Emer 25% of lineAl for Plan R~view <br /> .(~ec, ~), if requi~l <br /> C. Investigation Fee (if required) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />No, <br /> <br /> <br />