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FOR CITYxy~ATIO_N ] <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 Inq~ction Lin©: 588-7904 <br />Off.mo: 588-5147 8:00 a.m. - 4:30 p.m. <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Description <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 Contractor ~;~? ~-~._C+Y'~ Phone <br /> <br /> - I Phone <br /> <br />Mailing Address <br /> <br />Property Owner <br /> <br />Contractor's License No. 2 ~'~ ",~ ~/._~( ~ <br /> <br />Contractor's Board Reg. No. 1~O ~e..3 [ JobNo. ~ <br />Supervisor's License No. '~n~.-~ ~.~' phone~;~:~q~Z_i <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (please priat) <br /> <br />Mailing Address I Phone <br /> <br />City/State/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANRRVIEW 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 />MC 15-34 12/94 <br /> <br />Date: <br /> <br />4. FEE SCHEDULE (Complete and enter total in A 1 below) <br /> Number of Inspections per permit allowed <br /> R~idential <br /> Per <br /> Unit <br /> Service Included: Items Cost (each) Stlm_ <br />1000 sq. ft. or less __ .- $85.00 __ <br />Each additional 500 sq. ft. <br /> or portion thereof $15.00 <br />Limited Energy $20.00 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 ~ <br /> <br />B. Services or Feeders (Does not include branch circuits, see section D) <br /> installation, Alteration or Relocation <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 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 Servios~/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 />scc "B" above <br />D. Branch Cireults <br />New, Alterations, or Extension Per Panel <br />a) The fcc for branch circuits with <br />purchase of service of feeder fee <br />Each branch circuit $ 2.00 <br /> <br />b) The fee for branch circuits without <br /> pup;hase of service or feeder fee <br />First branch circuit <br />Each additional branch circuit <br /> <br />$35.00 <br />$ 2.00 <br /> <br />E. Miscellaneous (Service or Feeder Nog Included) <br />Each pump or irrigation circle $40.00 <br />Each sign or outline lighting $40.00 <br />Signal circuit(s) or a limited energy <br />panel, alteration or extension $40.00 <br />F. Each additional lnepzotion <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 $50.00 <br />(sold only to electricsl contractors) <br />H. Other <br />(As required by Building Ofl~cial) l. J l~ f~ ~ <br /> Aurora Dwelling Electrical Fee ~sq. fl. x$.06 = <br /> Dwelling Permit Label # of Labels <br /> <br />N/C <br /> <br />5. FEES Al. Enter total of fees from Sec.//4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <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 /> .-d~/~,..~TOTAL AMOUNT DUE <br />Receipt No. ~ <br /> <br />s <br /> <br /> <br />