Laserfiche WebLink
IFO; OFffICE USE ONLY <br /> Rec~i]fed <br /> Date: <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 22o Hig, Street NE <br /> <br /> Phone 558-$ l~7 g;O0 am - <br /> ~-A-~e: 588-7904 <br /> F~: 585-7~8 <br /> <br />PERMITS AR g NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />I~XPERE IF WORK IS NOT STARTED WITII[N 150 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />Contractoes Board Reg. No. ~"~ gq { Job No, <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Mailing Addvesa Phone <br /> <br />City/&ate~ip <br /> <br />The installation is being made on propsr~y I own which is not ~lte~ded for sale, <br /> <br />3. PLAN REVIEW SE~ I'ION <br /> <br />We will provide plan review semicc if you complete Section <br />5B and submit two (2) sets of plans and sp~gifications with <br />this application. <br /> <br />This optional plan review program doe.,~ not suspend the <br />reqaircxl submission of lighting power calculations, plans, <br />anti specifications when required by the Oregon Structmal <br />Specialty Code, Chapter 53, <br /> <br />MC 15-34 11191 <br /> <br />Date <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in A I below) <br /> <br />Ser,~ice Included: <br /> <br />10130 gq, fl, or lesa <br />Each ~.dd~tiom. l. 500 gq, lt., <br /> or po~ion thereof <br />Limited Energy <br /> <br />Items Co~t (each) SumJ <br /> $85.00 4 <br /> <br /> $~5,00 <br /> $20.00 <br /> <br />Each Manurd llome or Modeler <br />Dwelling Sewioe or Feeder $40.0O __ 2 <br /> <br /> 200 amps or less -- $50,00 ~ 2 <br /> 201 amps to 400 amps ~ $60.00 __ 2 <br /> 401 amps to 600 amps ~ $100,00 __ 2 <br /> 601 at, ps ~o 1000 amp~ ~ $130.00 - . Z <br /> Over 1000 amps or vohs ~ $300.00 .. 2 <br /> Rccomlec[ only $40.00 2 <br /> <br />C. T~mporary Service~/Fo~ders <br /> ln~tallatinn, ARerafion, or Relocation <br /> 200 amps or less <br /> 201 ~ps W ~0 amps <br /> <br /> b) ~e f~ for broach 5rcutz <br /> <br /> Signal ~uit(s) ~ a ~imd enemy <br /> <br /> Pack ~ 10 la~s ~ ~,00 ea~ .,, <br /> <br /> (As req~red by BuiMing Offic~l) <br /> <br /> 5. FEES <br /> <br /> ~, Add 5% su~a~a (-05 x <br /> <br /> (S~. 3). if <br /> C. ~ve~tigadon Fee (ff ~qaimd) <br /> <br />$35.00 <br />$40.00 ., 2 <br />$80.0O <br /> <br />$2,00 <br /> <br />$3500 <br /> $2.00 ., <br /> <br />$40.00 <br />$40,00 <br /> <br />$40,00 ~ 2 <br /> <br />$35.00 <br /> <br />$50.00 __ <br /> <br />Receipt No. ,,, <br /> <br /> <br />