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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE - Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspection Line: 588-7904 <br />Office: 588-5147 8:00 a.m. - 4:30 p.m. <br />FAX: 588-7948 <br /> <br />IELECTRICAL PERMIT APPLICATION <br /> P/ease complete al~ Section~, I through. <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Electrical ContractUal.d Z~' Ph°neyb <br /> <br />Conffactor's Board Reg No ' ~ ' Job No <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (please print) <br />Mailing Address [ Phone <br />City/State/Zip <br />Owner's Signature: <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 />specifications with this application. <br /> <br /> Num'ggrk~f ~~r permit allowed "-"l <br />A. Residential Per Unit ' ~' b l ]0[~ I <br />Service Included: Items Cost (each) Sum I <br />1000 sq. ft. or less $85.00 4 <br />Each additional 500 sq. ft. <br /> or portion thereof $15.00 <br />Limited Energy $20.00 1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 . 2 <br /> <br />B. Services or Feeders (Does not include branch circuits, see section D) <br /> Installation, Alteration or Relocetion / $50.~'-'~'~ <br /> 200 amps or less <br /> 2 <br /> 201 amps to 400 amps $60.00 ~ 2 <br /> 401 amps to ~00 amps $100.00 __ 2 <br /> 601 amps to 1000 amps $130.00 ~ 2 <br /> Over 1000 amps or volts $300.00 - 2 <br /> Reconnect only $40.00 ~ 2 <br /> <br />C. Temporary Services/Feeders <br />Installation, Alteration, or Relocation <br />200 amps or less $35.00 <br />201 amps to 400 amps $40.00 <br />401 amps to 600 amps $80.00 <br />Over 600 amps or 1000 volts <br />see "B" above <br />D. Branch Circuits <br />N~w, Alterations, or Extension Per Panel <br />a) The fee for branch circuits with <br />purchase of service of feeder fee <br />Each branch circuit $ 2.00 <br /> <br />$35.00 <br />$ 2.00 <br /> <br />b) The fee for branch circuits without <br /> purchase of service or feeder fee <br />First branch circuit <br />Each ad&tional branch circuit <br /> <br />__.sq. fl. x $.06 =__ <br /># of Labels. <br /> <br />E. Miscellaneous (Service or Feeder Not Included) <br />Each pump or irrigation circle $40.00 ~ 2 <br />Each sign or outline lighting $40.00 ~ 2 <br />Signal circuit(s) or a limited energy <br />panel, alteration or extension $40.00 2 <br />F. Each additional Inspection <br />Over the allowable in any of the <br />above, per Inspection $35.00 <br />O. Minor Installation Labels <br />Pack of 10 labels @ $5.00 each $50.00 <br />(sold only to electricM contractors) <br />H. Other <br />('As required by BuildiRg OfliciM) <br />Aurora Dwelling Electrical Fee <br /> Dwelling Permit Label N/C <br /> <br />5. FEES <br /> Al. Enter total oft~:cs from Sec. <br /> A2. Add 5% surcharge (.05 x Al) <br /> Subtotal <br /> <br /> B. Enter 25% of line Al for Plan Review <br /> (Sec. 3), if required <br /> C. Investigation Fee (if required) <br /> D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />MC 15-34 12/94 <br /> <br /> <br />