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I vo . vmc ONlY <br />~ Rece,ved by: <br />Date: .. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NB <br /> Salere, Oregon 97301 <br /> <br /> F~: 5~8-7~ ~ITE g; <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> <br />PERMITS ARB NON.TRANSI~RABLE AND NON-RBFUNDABLI~ AND <br />EXPIRE l~ WORK I$ NOT STARTIiD WITHIN 180 DAYS OF ISSUANCE <br />OR ~F WORK IS SUSPI~NDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Contractor'S Soa~ RcS. ~o, ~fi~ <br /> <br /> .... <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br />Pmpcny Owner <br />Mailing Address I Phone <br /> <br />We will provide plan review serv/ce if you Complete Section <br />5B and submit two (2) sets of plans and specitications with <br />this application. <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 the Oregon Structural' <br />Specialty Code, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />Date: <br /> <br /> Issued by: <br /> <br />4, FEE SCHEDULE (Completc Md enter total in A I b~low) <br /> <br /> R~tdential <br /> Per <br /> <br />]~ach additional ~00 sq, ft. <br />or po~,~ them. of $15.00 <br />Limited E~gy, ~ $20,00 <br /> <br /> Dw~lllns ${rvi¢~ or Fe~d~r $40,00 <br /> <br /> 200 amp~ c~less $50,00 <br /> 201 amps to 400 amps $$0.00 <br /> 401 aml~ to 600 amps $~00.00 <br /> ~Olam to 1000 amps $130,00 <br /> $$00,00 <br /> ?.ecotm~ct cedy $40,00 <br /> <br />C. Temporary Servlce~Eeeders <br /> lgstallatlon, Alteration, or <br /> <br /> 201 ~pa to ~0 <br /> 401 ~ps to ~0 amps <br /> <br />D, ~ranch Cimoi~ <br /> <br /> ~ch brach ~rcuit <br /> <br /> b) ~e f~ for ~eh Omats <br /> <br /> ~ ~di~m~ bm~ <br /> <br />g. Ml~ellan~us (Service otFeeder Not I~clu~ed) <br /> Bach ~mp or ~gafi~ cirde <br /> Ba~ si~ or ~e.~sh~g <br /> $i~ ~it(s) ~ a ~d e~y <br /> <br />E ~ch ~ditio~al <br /> ~e~ ~e aR~a~ ~ any of <br /> a~, p~ <br /> <br />G. Minor Installaiion Labels <br /> Pack ~ I0 la~s~ $5.~ <br /> (~old o~y to ~lealrkal <br /> <br />~. Othtv <br /> ( As ~q~red by Buildi~ <br /> <br />$C~,00 __2 <br />[40.00 <br /> 80,00 <br /> <br />$36,00 ~o~ <br /> <br />$40.00 <br />$40.00 <br /> <br />$40.00 ~2 <br /> <br />$85,00 ~ <br />$60,00 <br /> <br />Al. Enter total, of fe~s from $¢c.//4 <br />A2. Add 5% surchaq~e 605 x Al) <br /> <br /> Subtotal <br />B. Enm~ ~% ~ Ene A1 roi ~n <br /> <br />C. ~v~t~afi~ Fee (ff mqumd) <br />D. Re~x~fim Fee ($~,00) <br /> <br /> TOTAL AMOU~ DUE <br /> <br />RC~ipt No. <br /> <br />$ t,?~' . <br /> <br />$ <br />$ <br /> <br /> <br />