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]F~R OFFICE USE ONLY' <br /> Received by: ~ <br /> Date: '. .... <br /> <br /> MARION COUN3~ BUILDING INSPECTION <br /> <br /> #. <br /> FAX: ff8~7948 · ~.j~. <br /> E~CTRICAL PERMffAPPLICATION I Date: <br /> I <br /> <br /> PI~e ~lOtO ~l S~ions, I through 51 ~ ,S~' by: <br /> ,.. <br /> <br />PERMYI~ ARB NON-'IRANSFSRABLE AND NON-REPUNDABLE AND <br />HXPIRB IF WORK I~ NOT STAEFED WITHIN 180 DAYS OF I~S~UANC~ <br />OR lP WORK I5 SUSPENDED POR 180 DAYS. ~ <br /> <br />2A. CONTRACTOR IN~FALLATION ONLY <br /> <br />2B. FOR OWNER INSTiM.LATION$ <br />Property Owner <br /> <br /> I <br />~ Add~-..ss ] Phone <br />Ci~yP~ate/Zip <br /> <br />The instaHatlon is ,l~ng made on property I own wMch is net intond~l for sale, <br /> <br />3. PLAN REVIL'W SECTION <br /> <br />We will provide plan review service if you complete Section - <br />5B and submit two (2) sets of plans nnd specifications with <br />this application. <br /> <br />This optional plan review program does not suspead the <br />required submission of lighting power calculations, plans, <br />and specifications when required by the Oregon Structural <br />Specialty Code, Oapter 53. <br /> <br /> Nun.bar ~.lnspe~lons pa' pmnit aaowed '"l <br /> S~kel-duatd: ' ',~ItnM · Co.(eadO - S~m I <br /> <br />1000 sq. ft. or less .~ $85.00 .. 4 <br /> <br /> ~ Se~ee or Forxl~ : $40.00 2 <br /> <br /> 401 ~ to600amps $100.00 ,. 2 <br /> ~Ot ~ to 1000amps , . 2 <br /> ... $300.00 . 2 <br /> .~ , $40.00 ., 2 <br /> <br />C Temporas7 Services/Feeders <br /> lnslallatioa+ Al~raflon, or Rdocallou <br /> 200 arnps orkss <br /> 201 stops to 400 amps <br /> 401Sml~ to 600 amps <br /> Over 600 amps or 1000 volts <br /> <br />D. Braneh Circuits <br /> New, Alteration, or l~tendon Per Panel <br /> <br /> a) The fee for branch cbcuiu v~ <br /> _~rchase of sendce or feeder fee <br /> <br /> b) Thc fee for branch ~rcuts ~tho~t <br /> _purchase of service or feede~ fee <br /> <br /> FL~t branch circuit <br /> Each ndditio~a.1 branch circuit <br /> <br /> E. Misceitaneous (Service or Feeder Not Ineluded) <br /> · Each _l~mp or iniga~on circle . <br /> Each ~ or mLl~ lighting . <br /> Signal circuit(S) or · limited energy <br /> panel, elteration or extension <br /> <br /> E Each additional Inspection ' <br /> over ~ allowablc in any of ~ <br /> <br /> G, Minor Installation Labeb <br /> Pack of 10 labch O $5.00 each <br /> (soM o,ly to e~ctr~ml <br /> <br /> H, Other <br /> ( ~ required by Building Official) <br /> <br />$35.00 , 2 <br />$4O.O0 . 2 <br />$80.0O 2 <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. #4 <br /> A2. Add 5% surclmSe (.0~ x Al) <br /> <br /> Subtotal <br /> <br /> B. Enter 25% of line A1 for Plan Review <br /> (Sec. 3), tf required <br /> <br /> D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />$2.00 <br /> <br />$2.00 <br /> <br />$~o:oo <br />$40.00 <br /> <br />$40.0O <br /> <br />$,. <br /> <br />MC 15-34 11191 ~ ..~ ..... ~ Remir~No. <br /> <br /> <br />