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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <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 />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <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 />Mailing Address , <br /> <br />Contractor's License No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner (please print) <br />Mailing Address Phone <br />Cily/State/Zip <br />Owner's Signature: <br /> <br />3. PLANREVIEW 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 />PERMIT NO: <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below~ <br /> Nmnber of Inspections per permit allowed ----i <br /> Residential <br /> Per <br /> Unit <br /> ! <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 $15.1X) <br />Limited Energy $20.00 1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 ~ 2 <br /> <br />B. Service$ or Feeders (Do~s not include branch circuits, see section D) _ <br /> Installation, Alteration or Relocation i t~d <br /> 200 amps or less ~ $50.00 ~ 2 <br /> 201 amps to400 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 volta $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 volta <br />see "B" above <br />D. Branch Circuits <br />N~w, Alterations, or Extension Per Panel <br />a) The fee for branch circuit~ with <br />, purchase of service of feeder fee <br />Each branch circuit $ 2.00 <br /> <br />b) The fee for branch circuits without <br /> purchase of service or feeder fee <br />Firat branch circuit <br />Each additional branch circuit <br /> <br />$35.00 <br />$ 2.00 <br /> <br />E. Miscellaneous (~zrvice ~r Feeder Not Included) <br />Each pump or irrigation circle ~0.00 ~ 2 <br />Each sign or outline lighting $40.00 ~ 2 <br />Signal circuit(s) or n limited energy <br />panel, alteration or extension $40.00 ~ 2 <br />F. Each additional Inspee, tion <br />Over the allowable in nny of the <br />above, per Inspection $35.00 ~ <br />{3, Minor Installation Labels <br />Pack of 10 labels @ $5.00 each $50.00 ~ <br />(sold only to electrical contractors) <br />H. Other <br />(As required by Building O[l?cial) <br />Aurora Dwelling Electrical Fee <br />Dwelling Permit l..nbei N/C <br /> <br /> _si. Il. x$.06 = ~ <br /># of Labels <br /> <br />Al. Enter total of l~es from Sec. #4 $ <br /> , . <br />A2. Add 5% surcharge (.05 x Al) $ ~.~).~ ~ <br /> Subtotal $~ <br /> <br />B. Enter 25% of line A 1 for Plan Review <br /> (Sec. 3), if rcquirad <br />C. Investigation Fee (if required) <br />D. Reinapection Fee ($25.00) <br /> <br />TOTAL AMOUNTDUE <br /> <br />Receipt No. <br /> <br />MC 15-34 12/94 <br /> <br /> <br />