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FOR OFFICE USE ONLY <br /> Received by: <br /> Date: <br /> <br />lELECTRICAL PERMIT A,PPLIOATION" <br />Please complete all Sections, I through <br /> <br />L LOCATION OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Sweet NE <br /> Sale, m, Oregon 97301 <br /> <br /> Phone 588-5147 8:00 ~n - 4;30pm <br /> C~e-A-Phone: 588-7904 <br /> P~: 5SS-?~S SITE #: <br /> <br />Directions <br /> <br />PERNEI~ ARE NON-TRANSFEP~BLE AND NON-P-~ABLE A~D <br />I~XPI,P.E IF WORK I$ NOT STARTED W1TH]N 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPE~IDED FOR 1 S0 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Owner I Phone <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Pmpcny Owner <br />MeJllng Address Ph0nc <br />Ci~y/S~a~e/Zip <br /> <br />'Die ins[allarion is bols mad~ on pmpsny I own which is ~lx intended for sale, <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> We will provide plan review service if you complete Section <br /> 5B and submit two (2) se~s of plans and specifications with <br /> this application. <br /> <br />This optional pian review program does not suspend the <br />required sabmission of lighting pOwer calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Chapter 53. <br /> <br />Date: <br /> <br />Permit No, <br /> <br />Issued by: <br /> <br />4, FEE SCHEDULE (Complete and enter tota/in A ] below) <br /> <br />A, Residential Per Unit <br /> Service Included: <br /> <br />1000 sq, l~ or less <br />Each additional 500 sq. fi- <br /> or ps, Vim thereof <br /> <br />$15,00 <br /> <br />Lin',i~ed Energy $aO.O0 __ 1 <br />Each Manufd Home or Modolar <br />Dwelling $,rvio~ or Feeder $40.00 2 <br /> <br /> Servic~s or Feeders (Does not inlcudc branch ci r¢~iIs, see Suction D) <br /> Installatton~ Alterations or Relocation <br /> <br /> 200 amps ct less <br /> ~01 amps to 400 ~mps <br /> 401 amps to 600 amps <br /> 60! amps to 1000 ~mps <br /> Owr I000 amps et volxs <br /> Reconncri only <br /> <br /> C+ Temporary ServlcestFceder~ <br /> Installation, Alteration, or Relocation <br /> 200 amps or less <br /> 201 mnps to 400 aml~ <br /> 401 ammps s to 600 amps <br /> OVer 600 amps or 1000 v~Its <br /> <br /> D. Branch Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) The fee for branch drcuits wlth <br /> purchase of iervic~ ocfe~ler fee <br /> <br /> Each branch circuk $9.00 <br /> b) The f~ for branch limts ~ <br /> <br /> First branch circuit $35.00 <br /> Each additional branch circth[ $2.00 <br /> <br /> E. Mlscellant~utl (Service or Feeder Not Included) <br /> }[ach pump or inigatlon circle $40 <br /> Each ~ign or outline lighting __ $40,00 <br /> Signal circuit(s) or a limiu~d energy <br /> panel, alteration or extrusion . $40.00 <br /> <br /> over ~e allowable in any of ~h~---~;~ ~:&'. <br /> <br /> " Pack of .I0 la~.2~'@~5,00 ea~ <br /> (.~Old tJ~ly tO *l~¢f~cal ao~traetor$) <br /> , .,/ //-- .... <br /> <br />..... ............. <br /> ,Ai, ,'~ter trial ofines from Sec, #4 <br /> ~A2. ~tdd $% surcharge (,0S x Al) <br /> Subtotal <br /> <br /> B. Enter 2.5% of linc A1 for Plan Rcvlew <br /> (See. g), if <br /> C. Investigation Fee (if required) <br /> D. Reinspe. ction F~ ($25.~0) <br /> <br /> 'IDTAL AMOUNT DUE <br /> <br />50.00 <br />~60.00 __ <br />$100.00 __ 2 <br />$13o.oo __ <br />$300.00 __2 <br />$40,00 __2 <br /> <br />$35,00 <br />$40.00 <br />$80,00 <br /> <br />$ <br />$ <br /> <br />$ iq, <br /> <br />MC 15-34 11191 Receipt Nq. __ <br /> <br /> <br />