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FOR crrY VALIDATION <br /> Received by: <br /> Date:. , <br /> <br />IELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> 1. LOCATI~ALLATION <br /> <br /> D~ripaon \7_ X .b,O t,.d--h t'~ ~o~LE <br /> <br />MARION COUNTY BUILDING INSPECTIOk[/'/? COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE ' Room 132 <br /> Salem, OR 97301 <br /> <br /> Office: Phnne 55S-$147 8'00am ~ 4:3Opm <br /> FAX: S88-7948 <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. CON'TRACTOR INSTALLATION ONLY <br /> <br />Mai,ingAdd s 5:vw /sT /-//cz S' <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (p/e~g pr/tg.) <br /> Mailing Address I Phone <br /> City/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 />4. FEB SCHEDULE (Complete and enter total in Al below) <br /> Nmnber of Inspections per permit allowed <br /> Residential <br /> Per <br /> Unit <br /> ! <br />Service Included: lten~ Co~t (each) Sure f <br />1000 sq. ft. or less $85.00 4 <br />Each additional $00 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 ~ <br /> 200 amps or less ~ ~ $50.00 <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. Temp~ary Services/Feeders <br />Installation, Alteration, or Reloe. ation <br />200 amps or less $35.00 <br />201 amps to 400 amps $40.00 <br />401 a~nps to 600 amps $80.00 <br />Over 600 amps or 1000 volts <br />see *B~ above <br />D. Branch Circuits <br />New, Alterations, or Rxtonalon Per Panel <br />a) The fee for branch circuits ~ftth <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 ~j'vice 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 Not Included) <br />Each pump or irrigation circle MO.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 Inspection <br />Over the allowable in any of the <br />above, per Inspection $35.00 <br />O. Miner Installation Labels <br />Pack of 10 labels @ $5.00 each $50.00 <br />(sMd only to electrical coutrsctors) <br />H. Other <br />(As required by Building OtticiaD <br />Amora Dwelling Electrical Fee <br />Dwelling Permit Label <br /> <br /> sq. ft. x $. 068 = __ <br /># of Lalgls <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 />TOTAL AMOUNT DUE <br /> <br />Receipt No. <br /> <br />MC 15-34 1/96 <br /> <br /> <br />