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FOR OFFICE USE ONLY <br />Received by: ,, <br />Ii)ate:, '"' <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> Phone 588-5147 8:00 am - 4:307m <br /> FAXt 588-7948 SITE #: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />Date: <br /> <br />Issued by: <br /> <br />Permit NO, <br /> <br />1. LOCATION oF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFI~RABLE AND NONd~EFUNDAB LI~ AND <br />EXPIRE IF WORK IS NOT STAP,,TED wmg~r 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR lS0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />EIeerfiealContr~fIZER ELECTRIC INl~.h°ne <br />MaHingAdcimss 1410 MADISON ST. <br /> <br />378-0267 <br /> <br />Contraetof~ License No. 24 - 68 C <br /> <br />Prol~rty Owncr <br /> <br />C, ity~ta~/Zip <br /> <br />Owners Signature ,, <br />3. PLAN REVIEW SFX;TION <br /> <br />We will provide plan review service if you complete Section <br />511 and suhmlt two (2) ~ls of plans and specifications with <br />this applicatiou. <br /> <br />This optkmal plan re¥icw program does not suspend thc <br />reqtfircd submission of lighting power calculations, plans, <br />and spccil'ications when required by the Oregon Structural <br />Specialty C(×Ic, Chapter 53. <br /> <br />MC15-34 11/91 <br /> <br />d, FEE SCHEDULE (Ccanplete and enmr total in A 1 below) <br /> <br /> N#mbcr of Inspections per permit allowed <br /> <br />A. <br /> Residential <br /> Per <br /> Semite Included: Items Co~t (each) Sum/ <br /> <br /> 10~ sq, g. ~leaa $85,00 <br /> E~h ad~fi~l 5~ sq. ft. <br /> or ~ ~hemof $15.00 <br /> L~tcd E~e~y ~ $20.00 ~ <br /> Each Manufd Home or M~ular <br /> Dwe~ng ~ or F~er $40.00 <br /> <br />B. Servlc~ or Feeders ~oes not ~lcude branch cimuits, see sec~,[on D) <br /> lnatanafion, AIt~atlons ~ R~ation <br /> 2~ amps ~ less $50.00 ~ <br /> 201 ~s to 4~ amps ~ $60.00 <br /> ~I ~ to ~ amps ....... $300,~ ~ <br /> ~1 am~ to 1~ amp~ $130.~ ~ <br /> ~er 10~ ~ps or volt~ $300.~ ~ <br /> Re~,mec~ ~ly $40.00 <br /> <br />C. Temporary Servlc~/Peeders <br /> <br /> 200 amps or less <br /> 201 amps to 400 amps <br /> 401 arap~ to 600 amps <br /> Over 600 amps or 1000 volts <br /> <br />D, Branch Circuits <br /> New, Alteration, or Extension Per Panel <br /> <br /> a) Th~ fee for branch clrcrfits with <br /> p. tlrchas¢ of ~fviCe or feeder fe~ <br /> <br /> Each branch circtdt ~ <br /> <br /> b) The f~ for branch Otc'uts withont <br /> <br /> ! <br /> First branch cimuit <br /> Each addigonal branch ckeu/t <br /> <br />E. Miscellaneous (Service or Feeder Not Included) <br /> Rach pump or lrriga~m ciml¢ <br /> Each ~ign or ontlla¢ llght~ng <br /> Signal eimtfit(s) or a limited energy <br /> <br />E Each additional Inspection <br /> over the allowable in any of the <br /> above, per In apec~on <br /> <br />G. Minor Installation L~bels <br /> Pack of 10 labels @ $5,00 ~ach <br /> (void only to electrical contractors) <br /> <br />II. Other <br /> (As required by Building Official) <br /> <br />$3&00 <br />$40.00 __2 <br />SE0.00 <br /> <br />$2.00 <br /> <br />$35,00 <br /> $2.00 <br /> <br />$40.00 <br />$40.O0 <br /> <br />$40.00 <br /> <br />$85,00 ~, <br /> <br />$50.00 <br /> <br />5. FEES <br /> Al. En~r total of fees from Sec. #4 <br /> A2. Acid 5% surcharge (,05 x A I) <br /> <br /> Subtotal <br /> <br /> (See, 3). if mqulre, d <br /> <br /> D. Reinspecfitm Fee ($25.00) <br /> <br /> <br />