Laserfiche WebLink
FOR ciTY VALIDATION'I <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 285 Church St NE · Room 132 PERMIT NO: <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 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />J <br /> <br />Directiora <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 /> <br />Mailing Address LO. O< Og/ff <br /> <br />Con,ra¢,o. Li¢=¢ No. <br />Contractor's Board Reg. No. ~&'3~ 9 3 ]ob No. <br />Signature of Supe~ising Elec~ici~ ~~- . ~ <br />Supe,wisor's License No. J&~Y~ ~ Phone <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) <br /> Mailing Address I Phone <br /> City/State/Zip <br /> Owner's Signature: <br /> <br />3. PLAN REVIEW 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 />Date: <br /> <br />Issued by: <br /> <br />4.. FEll SCH]]DUL~ (Complete and enter tolal in A1 below) <br /> Nmnber ofhmpections per permit allowed <br /> Residential <br /> Per <br /> Unit <br /> Service Included: Items Cent (each) Sum <br />1000 sq. fl. or less $85.00 4 <br />F~ch additional 500 sq. ft. <br /> or portion thereof $15.00 <br />Limited Energ~ $20.00 1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 ~ 2 <br /> <br />B. ~ervic~s or Feeders (Does not include branch circuita, see section D) <br /> Installation, Alteration or Relocation <br /> 200 nmp~ or leas $50.00 ~ 2 <br /> 201 amp~ to 400 amps $60.00 __ 2 <br /> 401 ampa to 600 amp~ $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 Services/Feeders <br /> Installation, Alteration, er Relocation <br /> 200 amps or leg <br /> 201 nmp~ to 400 amps <br /> 401 amps to 600 amps <br /> Over 600 amps or 1000 volts <br /> see "B" above <br />D. Branch Circuits <br /> New, Alterations, or F-xt®nsion Per Panel <br /> a) The fee for branch circuits with <br /> purchase of service of feeder fee <br /> Each branch circuit <br /> <br /> b) The fee for branch circuits without <br /> purchase of service or feeder fee J <br /> First brnnch circuit <br /> Each additional branch circuit -~ <br />E. Miscellaneous {Service or Feeder Not Included) <br /> Each pump or irrigation circle <br /> Each sign or outline lightiog <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension <br /> <br />$35.00 __ 2 <br />$40.00 2 <br />$80.00 2 <br /> <br />$ 2.00 __ <br /> <br />sas.oo <br />$ 2.00 "~.~ <br /> <br />$40.00 ~ 2 <br />$40.00 ~ 2 <br /> <br />$40.00 ~2 <br /> <br />F. Each additional Inspection <br />Over the allowable in any of the <br />above, per Inspection $35.00 ~ <br />(il. 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 Official) <br />Aurora Dwelling Electrical Fee ~/. fl. x $.06 = ~ <br />Dwdling Permit Label # of Labels <br /> <br />N/C <br /> <br />5. FEES <br /> A 1. Enter total of lbes from See. #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 AMOUNTDUE <br /> <br />Receipt No. __ <br /> <br />MC 15-34 12/94 <br /> <br /> <br />