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'FOR 6F !c USE o. LY <br /> Rece!ved_by._~ I <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, O~egm~ 97301 <br /> <br /> Phone $88-~147 8:00 am - 4:30pm <br /> CW. le-A-Phon¢: Sg8-7904 <br /> FAX~ ~8.7~:~ SITE #: <br /> <br />P/ease complete afl Sections, I through 5 <br /> <br />Descrlpdon <br /> <br />PERMITS ARE NON-]la-ANSFERABLE ~ NON-R~FUNDABL[iAND <br />{gXPI~I~ IF WORK IS NOT STARTED WI'FI-UN 180 DAYS OF I~SUANCE <br />OR IF WORK IS SUSPJgNDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br />Electrical Co~tea~tor <br /> <br />Marling Address <br /> <br />Contractor's Board Reg. No. { J'ob No, <br /> <br />Signature of Sul~ffislng Electrician <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br /> <br />City/State/Zip / ~ ' <br /> <br />'~e inst~a~ is b~g made on p~y I own wN~ is nm ~t~nded for sale, <br /> <br />3. P~N REVIEW S~TION <br /> <br /> We wi{{ provide pl~ ~view semite if you complete S~fion <br /> 5g and submit two (2) sets of plans and specdieafions wi~ <br /> this applica~on, <br /> <br /> This optional plan review program does not suspend the <br /> required submission of lighting power calculations, plans, <br /> and specifications when required by th~ Oregon Structural <br /> Specially Code, Chapter 53, <br /> <br />MC I5-34 <br /> <br />Date: <br /> <br />PermR No, <br /> <br /> Issued by: <br /> <br />4, ~F; SCHEDULi'~ (CornpJt:tc and gntcr total in A [ below) <br /> <br />A, Residential Per UnR <br /> Service Included: <br /> <br />lOft/sq, ft. ct less <br />Each additional 500 sq, Pt, <br /> ct ~ tire.of <br /> <br />$85,oo .... 4 <br /> <br />$1S,OO <br />$20.00 1 <br /> <br />200 amps or le~s - $50,00 ~ <br />201 amps to 400 stops $60,00 2 <br /> <br /> 200 amps or less -, $35,00 <br /> 201 amps to 400 amps ~ $40.00 <br /> 401 amps to dO0 anaps -- $80.00 <br /> <br />Branch Cir~its <br /> NcW~ AIt~atlon, or ~tenslon Per Panel <br /> <br /> a) ~e f~ for bran~ ~tc~ts ~ <br /> <br /> ~ch brach ~rcuit ~ $2,00 <br /> b) ~e i'~ fct bran~ ~r~ts ~ <br /> <br /> Fb~t branch circuit ~ $35,00 <br /> Each addi~al bran~ circua $2.00 <br /> <br /> a~vc, pe Ns~on ., $35.00 <br /> <br /> ( As ~q~red by ~uiZ~ing Office/) . <br /> .... <br /> <br />A2. Add 5% ~ur~arge (.05 x A 1 ) $ ~ <br /> <br /> $ <br /> (S~. 3), <br />C, ~v~s~gatlonFce (g r~qui~d) $. <br />D. Reins~cti~ Fcc ($25.00) $ ...... <br /> <br /> <br />