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FOR CITY VALIDATION Received by: Date: MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMENT CENTER 285 Church St NE · Room 132 Salem, OR 97301 24 Hr Inspection Line: 588-7904 Offic. o: 588~5147 8:00 a.m. - 4:30 p.m. FAX: 588-7948 PERMIT NO: . '-' Date: Issued by: ELECTRICAL PERMIT APPLICATION Please complete all Sections, I through 5 1. LOCATION OF INSTALLATION Description PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. 2A. CONTRACTOR INSTALLATION ONLY Electrical Contractor ,.~ r~P~.-.~ Mailing Address PmPe~y Owner hon~ Contractor's License No. No. BUILDi Signat~e of Surmising Ele¢~ici~ Supc~isor's License No. Phone 2B. FOR OWI~R INSTALLATIONS 3. PLAN REVIEW SECTION Marion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 15-34 12/94 4. FEE SCHEDULE (Complete and enter total in Al below) Number of Inspections per permit allowed ----/ A. Residential Per Unit Service Included: Items Cost (each) Sum 1000 sq. fl. or less $85.00 4 Each additional 500 sq. ft. or portion thereof $15.00 Limited Energy $20.00 1 Each Manufactured Home or Modular ..~ Dwelling Service or Feeder $40.00 ~-- 2 B. Services or Feeders (Does not include branch circuits, see section D) Installation, Alteration or Relocation 200 amps or less ~ $50.00 ' 201 amps to 400 amps $60.00 -- 2 401 amps to 600 amps $100.00 __2 601 amps to 1000 amps $130.00 __2 Over 1000 amps or volts $300.00 - 2 Reconnect only $40.00 __ 2 C. Temporary Service~/F~xlera Installation, Alteration, or Relocation 200 amps or less $35.00 201 amps to 400 amps $40.00 401 alnps to 600 amps $80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits New, Alterations, or Extension Per Panel a) The fee for branch circuits with purchase of service of fccdcr fcc Each branch circuit $ 2.00 b) The fee for branch circuits without purchase of service or feeder fee First branch circuit Each additional branch circuit $35.~ __ $2.~ E. Miaeollaneona (Service or Feeder Not Included) Each pump or irrigation circle $40.00 __ 2 Each sign or outline lighting $40.00 __ 2 Signal circuit(s) or a limited energy panel, alteration or extension $40.00 ~ 2 F. Each a,dditional Inspection Over the allowable in any of the above, per Inspection $35.00 O. Minor Installation Labels Pack of I0 labels @ $5.00 each $50.00 (sold only to electrical contractors) H. Other (As required by Building Official) Aurora Dwelling Electrical Fee Dwelling Permit Label NIC sq. [1. x$.06 =__ //of Labels FEES Al. Enter total of fees from See.//4 A2. Add 5% surcharge (.05 x Al) $,__ Subtotal $.~ B. Enter 25% of line Al for Plan Review (Sec. 3), if required $.~ C. Investigation Fee (if required) $,__ D. Reinspeetion Fee ($25.00) $ TOTAL A oum' Receipt No.