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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NI~ * Room 132 PERMIT NO: <br />FOR CITY VALIDATION Salem, OR 97301 <br />Received by:. Dflto; <br />Date: 24 Hr laZ]l~Ctinn Line: 588-7904 <br />~"~ ...... .~ Off'~.~: 55S-g147 8:00 a.m. - 4:30 p.m. <br />.)! ~,,-'~/, ,~ '. ~ ,,"'.,..~,,'./,~ , ~ ~'~-a ~ FAX. SSil-7948 Issued by: <br /> <br />ELECTRICAL PER IT APPLICATIO '1 I <br /> Please complete ~1 ~tions, I through 5 { { 4. ~ s¢~ (~mplote and ~er tala{ ~ Al be]ow) <br /> <br /> 0 OF ~LATION ~ R~dential P~ Uflit <br />L LOCATI N ~rvi~ ludud~; Itm~ ~at (each) Sum <br /> <br />PF.J;[ MITS ARt/NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK I$ SUSPE. NDI~D FOR 180 DAYS. <br /> <br />2tl. FOR OW~ ]~$TALLATIONS <br /> <br />Propeay Owner (pl~sopt'inO <br /> <br />City/State/Zip <br /> <br />3. PLANREVIIi/W SI/CTION <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 /> 1000 sq. ft. or lean $85.00 4 <br /> Each additional 500 sq. <br /> or portion th~gof $15.00 <br /> Limited ]~nergy $20.00 <br /> Each Manufacturod Home or Modular <br /> Dwelling <br />) {~, ,°~rvlcen Or l~z[ ~- n (]~0¢a not include branch circuits, aec section D) <br />· ' "~'tn~ttallation, AJt~ation or Rolocatlon <br /> 900 amps or t¢~s ~ $$0.00 ~L.~_2 <br /> <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps <br /> 60t amp* ua 1000 amps <br /> Over 1000 amps or volB <br /> Reconnect only <br /> <br />C. Tempecary <br /> Installation, Alteration, or l/,eloe~tlon <br /> 200 amps or leas <br /> 201 a~llps to 400 amps <br /> 401 strips to 600 amps <br /> Over 600 amps or 1000 volts <br /> <br /> a) Th~ f~e for btaflch ¢imuits with <br /> <br /> Each branch circuit <br /> <br /> b) The £¢¢/'or branch clrculte ~ <br /> purchase ot'aeJX/.qg.gjT_l~_e~lcr fee <br /> <br /> Each additional branch circuit <br /> <br />$60.00., 2 <br />$100.00 2 <br />$130,00 2 <br />$300,00 2 <br />$40,00 2 <br /> <br />$35.00 <br />$40.00 <br />$80,00 <br /> <br />$2.00 <br /> <br />$35,00 <br />$ 2,00 <br /> <br />Miaeellanaous (8¢¢vi~ ~ Fe~l~t No{ Include) <br />~¢h pomp or i~gafion clinic ~.~ 2 <br /> <br />Signal eimult(s) or a limited energy <br />pan~l~ alt~ation or exgmion ~.~ 2 <br /> <br />Over t~ allowable in any of ~e <br />a~ve, per Inspsetion $35.00 <br /> <br />Pach of 10 hb¢ls ~ $5.~ each <br /> <br />Other <br /> <br />Al. Enter toteI ut fv~s fwm St~.//4 <br />A2, Add 5% su~haeg~ (.05 x Al) <br /> Subtotal <br /> <br />B+ ~ntet 25~ of line A 1 for Plan ~view <br /> <br />C. Investigation Fee (if~quimd) <br /> <br /> TOT~ ~OU~ DUE $~ <br /> <br /> <br />