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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />FOR CITY VALIDATION PERMIT NO' <br />Received by: Date: <br />Date: 24 hr. Inspection Line 3734427 <br /> <br />ELECTRICAL PERMIT APPLICA <br />Pieasecomplete~llSo~tions, I through 5 u ¥ j~. FEE SCH~E (Complcte and ent~ to~l in Al below) <br />.... <br /> <br />D~t~m Dwelling So. ice or Feeder ~0,~ ~ <br /> <br />PERMrrs 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 INSTALLA1'ln~ n~,n v <br />Parkin Electric, Inc. 20250 S Molalla Ave. <br />Oregon City, OR 97045 503-657-4958 <br />Contractors License #: 344C <br />Supervisor~: 4241-S <br />Contractors Board Reg: 35151 <br /> <br /> .............. s. ~,~,.' Job No. <br /> Signature of Supervising Electrician <br /> <br /> I <br />Supervianr's License No. I Phone <br /> <br />2B. FOR OWNER INSTALLATIONB <br /> <br />Property Owner (plaaso print) <br /> <br />M~iling Address I Phone <br /> <br />City/State/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANRBVIBW BBCTION <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 />B. Services or Feeders (Does not include branch circuits, see section D) <br /> Installation, Alteration or Relocation <br /> 200 amps or less $50.00 ~ 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 Services/Feeders <br />Installation, Alteration, or Relocation <br />200 amps or less $35.00 <br />201 amps to 400 maps $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 Per Panel <br />a) The fee for branch circuits ~ <br />purchase of ~ervice o~der fee <br />Each branch circuit $ 2.00 <br /> <br />b) The fee for branch circuits ~ <br /> purchase of s~__ryJ~e_or fe~dex]~ <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 $40.00 <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 />G. Minor Installation Labels <br />Pack of 10 labels @ $5.00 each $50.00 <br />(sold only 1o electrical contractors) <br />H. Other <br />(As required by Building OFficial) <br />Aurora Dwelling Electrical Fee <br />Dwelling Permit Label <br /> <br />__sq. fi. x $.068 = __ <br />//of Labels N/C <br /> <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 A 1 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 /> Receipt No. <br /> <br />$3b, <br /> <br />MC 15-34 1/96 <br /> <br /> <br />