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, , , ~ ,C~de-A. pho~e.4:SORM..8:OOA.M;;:.,: , ; , , <br /> ~,~t~ D~,~% ~S? MIT APPLICATION <br /> <br /> Jdb Address: '~ Site No.: <br /> C r.,o~ Stroe;; ................ <br /> Elec~cal Firm:~. /~__ Phone: AddreSs: <br /> su~e~isin~ Electrici~n~ . ~ Phone: Address: <br /> <br /> 8upervi~i.~ ~.. D/~ ~ ~ ~se of Residential ~ New ~ Addition ~ Occupan~ <br /> Commercial ~ Rdocetion ~ Change <br />....... Alteration ~ <br /> <br /> No. RESIDENTIAL <br /> __ Residencewiringlessthaol000sq, ft ................................. @$ 50,00 <br /> __,, Residence wiring less than 2000 sq. ft ................................. @ $ 75,00 <br /> Residence wiring over 2000 ag, ft .................................... @ $ 105.00 <br /> Electric heat installation in existing residence ........................... @ $ 30.00 <br /> SERVICES <br /> Temporary Construction Service ..................................... @$ 30.00 <br /> __ Service change only in an existing residence ........................... @ $ 30.00 <br /> Commen~lel or Industrial: <br /> __ Servicenotoverl00amperes ....................................... @$ 45.00 <br /> __ Service over 100 amperes but not more than 200 amperes ................. @ $ 70.00 <br /> Service over 200 amperes but not more than 400 amperes ................. @$ 100.00 <br /> __ Serviseover400amperesbutnotmorethenC00amperes ................. @ $ 150,00 <br /> __ ServiceoverC00amperes ......................................... @ $ 200,00 <br /> __. ServiceoverC00volts ............................................. @ $ 450,00 <br /> COMMERCIAL AND INDUSTRIAL FEEDERS <br /> Installation of Alterations or Relocation of Distribution Feedera: <br /> .~__ Not moretl~an 130amperes ........................................ @ $ 25.00 <br /> __ Overl00amperesbutnotmorethan200amperes ....................... @$ 40.00 <br /> -- Over200amparosbutnotmorethan400amperes ....................... @,$ 70,00 <br /> ..... Over400amperes ............................................... @ $ 85.00 <br /> __ FeederoverC00volts ............................................. @ $ 120,00 <br /> MISCELLANEOUS <br /> ~ A, Eachtrailerormobilehomespace(Servlceequlpment) .................. @$ 25.00 ~ ~'-~-- <br /> __. B. Each supply for moblie home (Connection) .... ........................ @ $ 25.00 <br /> __ C. Each irrigation pump (At~h a map showing location) ..................... @ $ 30.00 <br /> ___. D. Eachelectdcsignoroutlinelighting ................................ @$ 30.00 <br /> __ E. Each swimming pool (bonding) ................................... @ $ 30.00 <br /> BRANCH CIRCUITS <br /> -- Onenewcimuit;alterationorexteasloo ............................... ~$ 20,00 <br /> ..... Two or more new circults; alterations or extensions ....................... @$ 30.00 <br /> __ Other (as per NEC and Building Official) ......................................... <br /> __ On-SiteTechnicaIRevlew(applydirectlyatMarionCountyonly) ..3. .................. <br /> __ IndustriaIPlantlnspectJon(applydirectlyatMarionCountyonly) ...................... <br /> __ ReinspectlonFee . .................. .... @ $ 20,00 <br /> FEE <br /> STATE SURCHARGE <br /> Please return COMPLETE APPLICATION PLAN REVIEW FEE <br /> with the indicated fee. INVESTIGATION FEE <br /> FLEET SURCHARGE <br /> TOTAL $ <br /> <br />I ~gn~e to m~ke the e~octrtcat inetallatio according re the subTitle ~ specifications, the I~ws of the State of Oregon and the Ordin~nce~ of Marion County. <br />3,GNATURE OF APPLICANT: ~ ~ Job No: <br /> <br /> HOMEOWNERS - I hereby certify that I am the owner of the property described above, at which location I propose to ma{;e an electrical installation for <br /> my own use and this property is not being constructed for sale, lease or rent, <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />MC 15-34 (Owner doing his own work) <br />Rev. 12/88 <br /> <br /> <br />