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FOJ~ CITY VALIDATION <br />Received by: <br />Date: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all C)ections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTIONc-xx c-~ f~-~ <br /> <br /> 285 ~u~h St NE · R~m 132 <br /> 1111 <br /> <br /> Dine: <br /> ~ Hr In~t~n L~ <br /> O~: 58~5~47 8:~ a~. - 4:30 p.m. MARION COUNTY <br /> F~: ~ ~u~ b~qLDff~G''' <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. COHTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Propeny Owner (pleas~ pd~t) <br /> Mailing Address { Phone <br /> City/State/Zip <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 />A. Residential Per Unit <br />Set vice Included: <br />1000 sq. ft. or le~a $85.00 4 <br />Each additional 500 sq. ft. <br /> or portion lhereof $15.00 <br />Limited Energy $20.00 i 1 <br />Each Mnnufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 2 <br /> <br />B. 5ervice~ or Pnsdera (Doee not include branch circuibl, ~ ~e,',4ion D) <br /> Installation, Alteration or Reloeatio~ <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 10(X) amps or volta $300.00 -~ 2 <br /> Reconnect only $40.00 . 2 <br /> <br />C. Temporary 5ervieee/Feedera <br />Installation, Alteration, ~ Rdoeation <br />200 amps or le~ $35.00 ~ 2 <br />201 amps to 400 ~ $40.00 ~2 <br /> <br />Over 600 amps or 1000 volta <br />~e "B" aboYe <br />D. Branch Circuits <br />N~v, Alterations, or Extension Per Pansl <br />n) The fee for branch ¢ircuit~ with <br />p~chase 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 /> Fret branch circuit /.. $35.00,~'-~'' ~'~ <br /> Each ad&tional branch circuit $ 2.00 ~ <br /> <br />E. Miscellaneoua (Serviez or Feeder Hot Included) <br />Each pump o~ irrigation circle .~0.00 ~2 <br /> Each sign or outline lighting $40.00 .2 <br />Signal circuit(a) or a limited energy <br />panel, alteration or extension $40.00 ~ 2 <br />F. Each additional lnspzetion <br />Over the allowable in any of the <br />above, per lmpection $35.00 ~ <br />O. Minor Installation Labels <br />Pack of 10 labeh ~ $5.00 each $50.00 <br />(sold only to electrical contractors) <br />H. Other <br />(As required by Buii&'ng O~ei~O . . <br /> Auwra DwellingEleetrical Fee ~c!. ~. x$.06 = ~ <br /> Dwelling Permit Label # 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 Al for Plan Review <br /> (Sec. 3), if requircd <br />C. Investigntion Fee (if rcquired) <br />D. Reimpection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No..-- <br /> <br />MC 15-34 12/94 <br /> <br /> <br />