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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br /> 24 Hr lnap~tion Line,: 588-7904 <br />O fflor,: 388-5147 8:00 a,m. - 4:30 p,m_ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />L LOCATION OF INSTALLATION <br /> <br /> ...... ...... <br /> <br /> pERMITS AILE NON-TRANSFERABLE AND EXPIRE IF WORK IS NoT [ <br /> STARTED WITHIN 180 DA YS OF ISSUANCE OR IF <br /> I <br /> , WORK .... IS SUSPENDED FOR 180 DAYS, , <br /> <br />2A. CONTRACTOR INSTAJ~LATION ONlY <br />Electrical Contractor ] Phone <br /> <br />Job No, <br /> <br />2.18. FOR OWNER EqSTALLATIONS <br /> <br />3. PLAN REVIEW 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 /> spec'ficaUons with this application. <br /> <br /> ~ cOU~yy <br /> BI]iLDIN8 <br /> <br />4, F~ 8CH~L~ (Co~npl~lc and enter tolal in A 1 below) <br /> <br />A. <br /> <br /> IO~) Sq, fl. or less .... $85,~) .,, 4 <br /> <br />Installation, Alteration et R~lo~ntion <br /> <br />E. Miscellaneous (Serviceor Fe~d~r Not In¢lud~t) <br /> Each pump or irrigation ~ircI~ <br /> Each sign or outline: lighting <br /> SigmlI circuit(s) or a limited energy <br /> <br />p. Each additional laspt~fion <br /> Over the tdlowabl,~ in any of the <br /> <br />$50,00 ..... 2 <br />$60,00 2 <br />$100,00 2 <br />$130,00 __ 2 <br />$3~,00 -- 2 <br />$40.00 2 <br /> <br />$35.00 __2 <br />$40,00 2 <br />$~).00 __2 <br /> <br />$ ZOO <br /> <br />$35.00 <br />$ 2.00 <br /> <br />$40,00 .. 2 <br />$40,00 -- 2 <br /> <br />$40.00 -- 2 <br /> <br />$35,00 <br /> <br />$50.00 -- <br /> <br /> a/. ,q, x $.0~ =__ <br /># of L~b¢l~ __ ~ <br /> <br />5. FEES <br /> <br /> A2, Add 5% surcharge (,05 x A 1) <br /> <br /> rt. Enter2$% oflhleA[ for PlanReviow <br /> (8¢c, 3), i('~quired <br /> ¢, htwatlgatioa F~e (if required) <br /> D, Reiospeclion Fee <br /> <br /> TOT~ ~OD~r DUE <br /> <br /> <br />