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I FOR CITY VALIDATIONI <br />Received by.' <br />D~te: . <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE - Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373=4427 <br />Omce: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK 1S SUSPENDED FOR 180 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION ONLY <br /> <br /> 3¢S3 <br /> <br />2B. FOR OWNER INSTALLATIONS <br />l~opmy Owner (ple~ prior) <br /> <br />city/state/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANRItVlEW 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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> 4. FIlE $CHtiDIJI.ti (Complete and enter total in A1 below) <br /> Numbex of lmp~tiom po' l~nnit allowed <br /> A. Rmid~ntial Per Unit 1 <br /> Service Inohd~d: ltema ~ (each) Sumf <br /> 1000 sq. ft. or less $85.00 4 <br /> Each additional 500 sq. ft. <br /> or portion thereof $15.00 <br /> Limited Energy $20.00 1 <br /> Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 ~ 2 <br /> <br />B. Serviees or Feeders (Doe~ not include branch circuits, see section D) <br /> Installation, Alteration or Reloontlon <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 $150.00 ~ 2 <br /> Over 1000 amps or volts $300.00 ~ 2 <br /> Reconnect only $40.00 2 <br /> <br /> C. Temperary Serviee~/Feeders <br /> Installation, AJteration, or Relocation <br /> 200 amps or less $35.00 2 <br /> <br />40 1 amps to 600 amps $80.00 ~ 2 <br />Over 600 smp~ or 1000 volts <br />~ee "B" above <br />D. Branch Cirealta <br />New, Alterations, or Extenalon Per Panel <br />a) The fee for branch circuits with <br />_m~rchnse of service of feeder fee <br />Each branch circuit $ 2.00 ~ <br /> <br /> b) The fee for branch circuits without <br /> purchase of ~ervice or feeder fee <br /> Fa'st branch circuit $35.00 <br /> Each additional branch circuit $ 2.00 ~ <br /> <br />E. Miseeflaneous (Service or Feeder Net Included) <br />Each pump or irrigation circle / $40.00 <br />Each sign or outline lighting $40.00 ~ 2 <br />Signal circuit(0 or,, limited <br />panel, Hl~tion or ext~mion $40.00 __'2 <br />F. ~ch additioml l~tion <br />Ov~ th~ allowsble in ~my of the <br />sbove, IX'r Impcction $3~.00 __ <br />G. Minor ln~lhtio~ <br />Pack of 10 i~h ~ $3.00 each $50.00 ~ <br />(~ld O~ly I~ el~etricM eo~tmctorO <br />H. Other <br />(A~ re4~/red by B~ild,'~ <br />Aurora Dwelling El~otrie~l F~ sq. fl. · $.06~: __ <br />Dwelling l~mit I. abel # of Lal~la N/C <br /> <br />Al. Enter total of fee~ from Sec.//4 $ <br />A2. Add 5% surchnrge (.05 x Al) $ <br /> Subtotal $ <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Sec. 3), if required <br />C. Investigation Fee (if required) <br />D. Reimpection Fee ($25.00) <br /> <br />Receipt No. <br /> <br />TOTAL AMOUHT DUE <br /> <br />MC 15-341/96 <br /> <br /> <br />