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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br /> <br />FOR CITY VALIDATIONl <br />Ro~eived by:~ I Salem, OR 97301 <br /> <br /> Off<e: 588-5147 8:~a.m.-4:30o.m. <br /> <br />Pleaso comp/otc gl 8~tions, I through ~ <br />1. LOCATION OF mST~LATION ~ARI~N ~0 J~vi~lnelud~:~id~tia' p~ Unit Itelm C~t <gaeh) S <br /> <br />DUILL~IPlta I <br /> <br /> II .... <br /> <br />PER.TS A~ NON-~NS~B~ AND ~P~R~ W WORK ~ NO~ <br />STARED ~ l~ DAYS OF ISSUAN~ OR IF <br /> WO~ IS $USP~D~ FOR 180 DAYS, <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />Mailiog Addle <br /> <br />Contractor's Board Rag, No, <br /> <br />Signature of Supervising El~tfioitm <br /> <br />Job No, <br /> <br />-[ <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />3. PLANRIqVII~/W 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 />t . of less 4 <br /> <br /> Limited Enm~y $~0.00 <br /> Dwelling Servlec ce Feedee $40.(~) __ 2 <br /> <br /> Installation, Alteration or Relocation <br /> 200 amps or I¢~ <br /> 201 amps to 400 amps <br /> ~01 amps tO 600 al~p~ <br /> 601 amps to 1000 amps <br /> Over I000 amps or volts <br /> <br />C. T~nnporary P~rvic~dFted~rs <br /> <br /> 200 amps or leas <br /> <br />b) Thy fee for branch elreulta <br /> purchase of service or <br />First branch cimuit <br />~ch additional bnmch circuit <br /> <br />$ L(YO,O0 -- 2 <br />$130.00 2 <br />$300,00 2 <br />$40,00 2 <br /> <br />$35.00 2 <br />,'~),00 2 <br />$~100 12 <br /> <br />$ 2100 <br /> <br />$35 ,oo <br />$ 2.oo <br /> <br />E1 Miaedlaneoua (Seevico et Ftmdor Not Included) <br />Each pump or ~gation oiml~ ~100 <br />~gh sigm or outline light~g ~.00 2 <br />Signal ¢i~uit0) or a limited <br /> <br />show. p~r Impection <br />O. M~ lnataEation Label~ <br />Pa~k of 10 l~ala ~ $5.~ each $30.~ . <br /> <br />H. 0~ <br /> (~ requitvd by Buildi~ <br /> Aumm Dwelling gleelfical F~ ~.~. ~. x $.~ <br /> Dwdling Pe~it ~bel <br /> <br />5, PEI~$ All Enter total oft'ecs from Sec. #4 <br /> A2, Add 5% aumharge 605 x Al) <br /> <br />$ d,~ TM <br />$ <br /> <br /> (StOl 3), it'required <br /> <br />D. Reio~p¢¢ lion Fee ($23.1×)) <br /> <br /> <br />