Laserfiche WebLink
FOR CITY VALIDATIONI <br />Received by: [ <br />Date: [ <br /> <br />MARION' COUIgI'Y BUILDING <br /> COMMUNITY DEVEL~O?MENTCENTER Ill|~""' ~ ""/?P Ill I <br /> 285 Church St NE Room 132 <br /> I"'a'rtllffl I · n I fi/ · <br /> Salem, OR 97301 <br /> Date: MAR!og COiJt~ F¥ <br /> <br />24 Hr In~etion Lin~.' 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 />,obAddrcss //bqtO0 )~ff~t/ <br />City~ f <br /> <br />Directions <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 /> 'r:JUILDIIVG I[VSPECThqt,~ <br />Issued by: <br /> <br />4. FI]II $CI'I]~DU~E (Complete and enter total in Al below) <br /> <br />A. Rwidential P~' Unit Numberoflnspections per permit allowed <br />Service included: Items Cost (each) Sum <br /> <br /> .~" ; ,~ ~" -- ,' ~ I I 1000 sq. ft. or less $85.00 4 <br />~[/~/'197 /9,~ /~//~/ j~//--~. [ ] ~chadditionalS~sq. ft. <br /> ~ .... i ] or ~dlon ~e~of $15.~ <br /> ~s,./~.~W/d/~t/~]~ I I~mitedEaergy $20.~ 1 <br /> ~ ...... ~a'~ ~7 ~'~ K J ~ch Manufactu~ Home or Modular ~ <br /> ~ ~& 6~[/~ ~elling Se~iee or ~eder / M0.~ ~2 <br /> B. 8~i~ ~ P~ (~a not include brach eimuith see section D) <br /> In~alhtion, ~t~ati~ ~ R~l~ti~ <br /> ~ ~ or le~ $~.~ <br /> 201 amps to ~ am~ $~.~ ~ <br /> ~1 am~ to ~ am~ $1~.~ <br /> ~1 am~ to 1~ ~p, $1~.ffi __ <br /> ~er 1~ ~ps or volta $3ffi.~ - <br /> Re~nneet only ~.~. ~ <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br />Parkin Electric, Inc. 20250 S Molalla Ave. <br />Oregon City, OR 97045 503-657-4958 <br />Contractors License #: 34-4C <br />Supervisor #: 1313-S <br />Contractors Board Reg # 35151 <br /> <br />Supervisor's License No. Phone <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner (please print) <br /> <br />Mailing Address I Phone <br /> <br />Cily/State/Zip <br /> <br />Owner's Signature: <br /> <br />:3. PLANRRVIBW SIiCTION <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 />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 volts <br />see "B" above <br />D. Branch Circuits <br />New, Alterations, or Extension P~r Panel <br />a) The fee for branch circuits :~fith <br />purchase of service of feeder fee <br />Each branch circuit $ 2.00 <br /> <br />b) The fee for branch circuits wilhout <br /> purchase of service or feeder fee <br />First branch circuit <br />Each addhional branch circuit <br /> <br />$35.~ <br />$2.~ <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, alteration or extension $40.00 ~ 2 <br />F. Each additional Inspection <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 OEicial) <br />Aurora Dwelling Electrical Fee <br />Dwelling Permit Label N/C <br /> <br /> sq. tl. x $.06 = ~ <br /># of Labels <br /> <br />Al. Enter total of fees from Sec.//4 <br />AZ. Add 5% surcharge (.05 x Al) <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 12/94 <br /> <br /> <br />