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o ' MARION COUNTY BUILDING INSPECTION <br /> <br /> 285 Church St NE · Room 132 p <br /> Salem, OR 97301 ~~~ <br /> ~Hrln~t~nL~e: 58~7~ ~~--r~ ~ ~"~ <br /> Om~: 588-5147 8:~ a.m. - 4:30 p.m. ~ <br /> F~: 588-794S ~ <br /> <br />PIoa, o com~loto ~l ~ocHon~, ~ t~ro~ ~ 4. F~ SC~~ (Complete ~nd ent~ to~l ~ Al b~low) <br /> <br />FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Directions <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 />2B. FOR OWI~R INSTALLATIONS <br /> <br />Property Owner (please print) <br /> <br />Mailing Address { Phone <br /> <br /> City/State/Zip <br /> <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 /> Number of Inspections per permit allowed --~ <br /> Rmidential <br /> Per <br /> Unit <br /> ! <br />Sorviee Included: Items Co~t (each) Sum <br />1000 sq. fl. or less $85.00 4 <br />Each additional 500 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 />Bo <br /> <br />Services or Feeders (Does not include branch circuits, sec section D) <br />Installation, Alteration or Relocation <br />200 amps or less / $50.00~ g~rZ}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 Sorviees/Feedors <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 />Now, Alterations, or Extension Per Panel <br />a) The fee for branch circuits ~ <br />pu~c~hase 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 />First branch circuit <br />Each additional branch circuit <br /> <br />$35.00 -- <br />$2.00__ <br /> <br />E. Miscellaneous (Sorvie~ or Fo~dor Not Included) <br />Each pmnp 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 lnap~tion <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 OfficiM) <br />Aurora Dwelling Electrical Fee <br /> Dwelling Permit Label N/C <br /> <br /> ~1.1t. x $.06 =__ <br /># of Labels <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> Subtotal <br /> <br />B. Enter 25% of line Al for Plan Review <br /> (See. 3), if required <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br />TOTAL AMOUNT DUI~ <br /> <br />Receipt No. <br /> <br />MC 15-34 12/94 <br /> <br /> <br />