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FOR. OFFIC_~'E.U?Ea~N~_LY ] <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br />ELEOTRICALPERMITAPPLIOATION 1 A~j~ 1!} l~g Date: t.r~,,~%~/,~'?/ <br />Please complete afl Sections, I through 5 J MARION COUN]'¥ Issued by: <br /> <br /> BUILDIN~ <br />I. LOCATION OF INgTALLATION <br /> <br />PERMITS ARB NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WI'FH IN 180 DAYS OF ISSUANCE <br />OR I]7 WORK IS SUSPENDED FOR 1 S0 DAYS, <br /> <br />2A, CONTRACFOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INb'I'ALLATIONS <br /> <br /> Addms_.,. _.. · <br />City~ta~}p <br /> <br />Tbe imt~la~n is being mad~ on p~Ry I own w~ is ~o[ ~ded for <br /> <br />3. PLAN REVIEW SE~ION ~ <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 />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 Cede, Chapter 53. <br /> <br />MC 15-34 11/91 <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below) <br /> <br /> Number of Inspections per perml( allowed <br /> <br />A, <br /> Residential <br /> Per <br /> Unit <br /> Service Included: Items Cost (eael~) Suml <br /> <br /> 1000 sq, fl, or less $85.00 <br /> Each aSditiona1500 sq, ft. <br /> Or poRion [hereof $15,00 <br /> Limit od Encrgy -- $20.00 __ <br /> <br />Each Manufd Ilome or Modular <br /> DweRing Servi~ or Feeder <br /> <br /> $40,00 <br /> <br />Services or Feeders (Docs not inlcude branch cir~.0ils, see <br />Ins~mllatlon. Alterations or Relocation <br /> §0,00 <br /> 200 amps or less $ $60,00 <br /> 201 amps to 400 amps <br /> 401 amps lo 600 amps $100.00 <br /> 601 amlp~s to 1000 amps $130.00 <br /> Over 1000 amps or volts -- $800.00 <br /> Reconnect only __ $40.00 <br /> <br /> 200 amps or less $35.00 <br /> 201 amps to 400 amps -- $40.00 __ 2 <br /> 401 amps to 600 amps -- $80.00 __ 2 <br /> Over 600 amps or 10O0 volts <br /> <br />D, Branch Cir~ui~ <br /> <br /> a) The fcc for branch ~rcUlts wlth <br /> <br /> b) The fe¢ for branch drcuts wN19;~; <br /> <br /> Each pamp or irrigation circle $40,00 __ 2 <br /> Sigrlal circuit(s) or a llmi~d enezgy <br /> <br /> FEES <br /> <br />Al, Enter total of ~es from Sec. #4 <br />A2, Add 5% surcharge (.05 x A I ) <br /> <br /> Subtotal <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (S¢c, 3), if required <br />C. InvestigationPe¢ (ff required) <br />D, R¢inspecfiem Fee ($25,00) <br /> <br />, '3& <br /> <br />$ <br />$ <br /> <br /> <br />