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F~OR CITY VALIDATION <br />Re. circA b~v; <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PiCRMIT NO: <br /> Salem, OR 97301 <br /> <br /> Oato: <br />24 Hr Inspection Line~ 588-7904 <br />Off'ice: 588-5147 8:OOa_m.-4z30p.m, <br />FAX; 588-7948 Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS AR~ NON-TRANSFERABLE AND EXPIR~ IF WORK I$ NOT <br />STARTE~ WITHIN [80 DAYS OF ISSUANCE OR IF <br /> WORK I$ SUSPENDED FOR 180 DAYS. <br /> <br /> CONTRACTOR INSTALLATION ONLY <br /> <br />~pc~y Owner I ~nc <br /> <br />C~m~actor's Boa~ Reg. No. ~'"~ .-.~ lO ,/ } Job No. <br /> <br />$igaamm of Supervising ~eqt~ieinn <br />Sup~rvlsor's £1cense No. <br /> <br />3. PLAN RBVIEW SECTION <br /> <br />Marion County does not require a plan review, <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-.74 12gYM <br /> <br /> 4. FE'I~ SCHE, DULI~ (Complete and enter ~olal in Al below) <br /> ~ R~idential p~ Utl~t Number of lnsp~tions p~ pe~it allowed~ <br /> <br /> 1~) sq. ft, or less $85,~ ~4 <br /> <br /> Dwelling sc~ice or F~eder <br /> <br /> 200 mnps or le~ $50.00 <br /> 201 ~mps to ~) amps $~L00 ~ <br /> ~1 amps to ~ <br /> ~l am~ to i000 <br /> Over 10~ mnp~ or vol~ $3~.00 <br /> Reconnect only $~.00 <br /> <br /> 200 am~ or less $35,~ <br /> ~l amps ~ ~0 amps ~.~ <br /> ~1 amps to ~ amps $~.~ <br /> <br /> a) ~e f~ for <br /> oute~se of se~ie~ feeder fee <br /> ~ch branch ci~B{t $ 2.~ <br /> <br /> Fi~ brach ci~it $35,00 <br /> ~ch additional brach <br /> <br /> ~eh pump or i~ig~fion <br /> ~h si~ or outline lighti~ $~.~ ~ <br /> $ignal oiguil(s) or a limited enegy <br /> pan~l, al~.fion or extemlon $~,00 <br /> <br /> above, per Inspeet~n $35.00 <br /> <br />PRe[ of 10 labels ~ $5,~ eagh $50.~ <br />(s~d only to electrical contractors) <br />R, Ot~ <br />(~ ~qui~d by <br />Aum~ ~welli~ ~eetfieal <br />~elli~ Permit ~bcl <br /> <br />5. <br /> Al. Eater total of ~s f~m $~. ~4 $~ <br /> A% Add 5% su~ha~e (.05 X Al) $~ <br /> Subt~al $.__ <br /> <br /> (Sec, 3), if raq~i~d $.~ <br /> C. ]nveatigation Fee Of required) $. <br /> <br /> T~T~ <br /> <br /> <br />