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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 n.m. - 4:30 p.m. <br /> <br />IELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Directions <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 /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (pleas~ print) <br /> <br />Mailing Address J Phone <br /> <br />City/State/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLAN REVIEW SRCTION <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 />4. FEE SCHEDULE (Complete and enter total in Al below) <br /> Number of Inspections <br /> per <br /> p~rmit <br /> allowed <br />A. Reeidential Per Unit [ <br />Service Included: Items Cost (each) Sum <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 Fm~lers (Does not include branch circuits, see section D) <br /> Installation, Alteration or Relocation <br /> =00 amps or less / S 0.00 <br /> 201 amps to 400 amps $60.00 ~ 2 <br /> 401 amps to 600 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. Tempocary Services/Feeders <br /> Installation, Alteration, or Relocation <br /> 200 amps or less <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps <br /> Over 600 amps or 1000 volts <br /> see "a" above <br />D. Branch Circuits <br /> New, Alterations, o~ Extension Pm' Panel <br /> a) The fee for branch circuits <br /> ourchase of service of feeder fee <br /> EaCh branch circuit <br /> <br />b) The fee for branch circuits without <br /> purchase of service or feeder tee <br />First branch circuit <br />Each additional branch circuit <br /> <br />$35.00 ~ 2 <br />$4o.00 ~ 2 <br />$80.00 __2 <br /> <br />$35.00 <br />$ 2.00 <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, alteratiou or extension $40.00 __ 2 <br />F. Each additional Inap~tion <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 electrical contractors) <br />H. Other <br />(As required by Building Ol~ciaO <br /> Aurora Dwelling Electrical Fee ~.sq. E. x $.06 = ~ <br /> Dwelling Permit Label # of Labels NIC <br /> <br />FEES ~ <br />Al. Enter Iotal of fees from Sec.//4 <br /> A2. Add 5% surcharge (.05 x Al) $ .2 ~ <br /> Subtotal $.~ <br /> <br /> B. Enter 25% of line A l for Plan Review <br /> (Sec. 3), if required $.__ <br /> C. Investigation Fee (if required) $ <br /> D. Reinspection Fee ($25.00) $.__ <br /> TOTAL AMOUNT DUE $ ~ O.~' <br /> Receipt No. <br /> <br />MC 15-34 12/94 <br /> <br /> <br />