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OrHC oNLY I <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMITAPPLiCATION <br />Please complete all Sections, I through <br /> <br />Salem, Oregon 97301 ~J ~ L.;:.,./I-iJ <br />~e-A-~r 588-7~ Permit No, <br />F~: 5$S-7~s SITE ~: <br /> ~IARION COUNTY <br /> Date: ~-~,* ....... <br /> <br /> Ismed by: <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STAKT F,D VvTflrl~[ 1 se DAYS OF ISgrJANCE <br />OR IF WORK IS SUSPF~NDED FOR 180 DAYS. <br /> <br />lob No. <br /> <br />2A. CON'IllACTOR INSTALLATION ONLY <br />gleoh-ical C~[ra~tor <br /> <br />C~)ntractofs Board Reg. No. ~L <br /> <br />Sisnatam of <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Owner <br /> <br />MaL!ing Address, .... [Phone <br />City~tate~ip <br /> <br />'I]~= installation i~ being made on pml~ I own wM~ is ~lo{ intended for sale, <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />th~s application, <br /> <br /> This optional plan roview program does not suspend the <br /> required submission of lighting power calculations, plans, <br /> and specifications when required by thc Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br />MC ].~-34 H/9,1 <br /> <br />4. I~E SCHEDULE (COmplete and enter ~ot~l in A1 below) <br /> Numt~r of Inspections per permR allOwe~ --~ <br /> Residential <br /> Per <br /> Unit <br /> / <br /> <br />1000 aq. Ix. or h~ss ~ $05.00 4 <br />Ba~h addillonal 5~) sq, ft. <br />or po~c~a thereof $15.00 ~ <br />Limited l~er~y ~ $8O.00 1 <br />Bach Manufd Home or MOdular <br />DweBing Service or Fe, ed e~ $40.00 2 <br /> <br />~. $er,flee~ or Fet,~r s (Does not ~leude b~anch e~realt~, see seetkm D) <br /> Installation, Alterations or R~qoeatlon ~._ ~ ~.,~.~ ~ <br /> 200 ~-ni~ or less ~ $S0.00 <br /> 201 aml~ to 400 amp~ $60.00 . ~ <br /> 401 ~,nps ~o 600 amps $ff00.00 ~ <br /> 601 ~nl~ to 1000 ~m~ $~ S0.00 __ 2 <br /> Over I000 ~mps or volt~ $300.00 ~ 2 <br /> Reootmeet oaty ~ $40.00 __ 2 <br /> <br />C. Temporary <br /> Installation, Alteration, or Rd~atlon <br /> <br /> 201 ~pa to ~ ~p~ ~ $40,00 <br /> 401 ~ps <br /> ~ ~ ~p~ or 1~ vol~ <br /> <br />D, Branch <br /> <br /> a) %e f~ <br /> <br /> b) ~ f~ <br /> ~tehase of <br /> <br /> F~t b~n& ~t ~ $35.00 <br /> Each ~on~ b~nch ~ ~ $2,00 <br />E, ~etlan~us (Servt~ or F~er Not Included) <br /> ~ ~mp ~ i~ga~ ~e ~ $40,00 <br /> <br /> Sign~ dinA(s) <br /> <br /> (As ~quired by 8~gdlng <br /> <br /> <br />