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MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMENT CENTER VALIDATIONI 285 Church St NE · Room 132 ReceivedCITYby: II .(~ Salem, OR 97301 24 Hr lnsl~:fion Line: 588-7904 Office: $88=$147 8.-00 a,m. - 4:30 pan, FAX: 588-7948 Date: L~su ed by: ELECTRICAL PERMIT APPLICATION Please complete all SectiOns, I through 1. LOCATION OF INSTALLATION PERM1TS ARE NoN-TRANsFERABLE AND ~XP~ IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. 2A. COHTRACTOR INSTALLATION ONLY 2B. FOR OWNER INSTALLATIONS Property Owner (pi~s~pd~t) Mailing Address City/State/Zip Phone IOwner's Signature: 3. PLANREVIEW SECTION rMarion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 15-34 12/94 4. ~gt]~l~ ~C~]~DULi~ (Complate and enter total m Al ~w) N~ of~ ~ ~it ~w~ ~ R~d~i~ P~ U~ ~~: 1~ ~(~h) S~ ~ I~ ~. · ~ ~ $85.~ 4 ~n~ $15.~ ~ M~f~ H~ or M~ ~dl~ ~ice or ~ ~.~ 2 B. 8ervio~ or Fmn~ra (Doe~ not include branch circuits, nee section D) Installation, Alteration or Redoeation 200 an~ or leto $50.00~. ~ 2 401 amps to6OOamps $100.00 __2 601 amps to 1000 amp* $130.00 . , 2 Over l000 amps or volta $300.00-. ,,. 2 Reconnect only $40.00 ~ 2 C. T-mporary Servie~eeders Installation, Alteration, or Rdooation 200 an~ or less ~ 201 aml~ to 400 amps Over 600 amps or 1000 volta see "B" above D. Branch Cireuits New, Alterations, er Extension Per Pand a) The fee for branch aireuita ~ .marehase of aervice of faeder fee Each branch circuit $80.00 ~2 $ 2.00 __ b) The fee for branch circuits without pureha~ of service or feoder fee Fkst brmch ¢i~uit Each additional branch circuit $35.00 E. Miamdlan~ous (~n'vi~ er Feeder Not lneluded) ~ ~p ~ ~ga~n c~le ~.~ Si~ c~s) ~ a i~d en~ ~ei, alt~ ~ exmi~ F. ~ a~R~l i~i~ ~r ~ al~able ~ ~y of ~e ~ ~ ~n $35.~ __ O. M~ In~t~ ~b~ Peck ~ 10 I~ ~ $5.~ ~eh $~.~ ~ H. ~ (.4~ required by ~uitdi~ O~ciaO Aurora Dwelling Electrical Fac Dwell/ag Permit Label # of Labels. N/C Al. Enter total afl, es from Sec. ~4 $ A2. Add 5% iurcha~e (.05 x Al) $__ ~ubtotal $ B. Enter 25% of line Al for Plan Review (Sac. 3), if required $~ C. Investigation Fee (if required) $ . D. Reimpecfion Fee ($25.00) TOTAL AMOUNT DUE Receipt No.