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FOR (~FFICE USE ONLY Received by:. 220 High Street NE Salem, Oregon 97301 Date: Phone 588-5147 8:00 am - 4:30pm Code-A-Phone: 588-7904 P/ease complete all Sections; I thro *l 5; v I 3 199 MARION COUNTY BUILDING INSPECTION SITE #: Date: Issued by: Permit No. 1. LOCATION OF INS~rALLATION BUILGiNG linc JobAddress 14452 ARNDT RD city AURORA I CrossSt. AIRPORT WAY Directions COLUMB IA HELI COPTERS Descdption I~RFH~.II~F RFMI1DFI PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. 2A. CONTRACTOR IN~rALLATION ONLY FRAHLER ELECTRIC ]Phone'639-4627 Electrical Contractor MARION COUN MailinsAddress 11860 sw GREENBURG RD, TIGARD PmpartyOwnerCOLUMBIA HELICOPTERS IPhfs~78'1'222~ Contractor's Liconse No.3 4- 1 3 C Contractor's Board Reg. No. 3741 0 IJ°bN%6072 Signature of Supervising Electrician ~nf~ Supervisor's License No. 1~ 6 I Phone No. 6 3 9- 4 6 2 7 2B. FOR OWNER INSTALLATIONS Property Owner Mailing Address City/State/Zip Phone The installation is being made on property I own which is not intended for sale, lease, or rent. ~Q~V Owner's Signature 3. PLAN REVIEW SECTION We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. This optiona! plan review program does not suspend the required submission of lighting power calculations, plans, and specifications when required by the Oregon Structural Specialty Code, Chapter 53. MC 15-34 Ill91 Y 4. FEE SCHEDULE (Complete and enter total in A1 below) FION A. Residential Per Unit Service Included: Number of Inspections per permit allowed -~ / Items Cost (each) Sum/ 1000 sq. ft. or less $85.00 4 Each additional 500 sq. ft. or portion thereof $15.00 Limited Energy $20.00 ~ I Each Manu£d llome or Modular Dwelling Service or Feeder -.. $40.00 ~ 2 B. Services or Feeders (Does not inlcude branch circuits, see section D) Installation, Alterations or Relocation~ ~' 350.00 5 0 2 200 amps or less 201 amps to 400 amps $60.00 2 401 amps to 600 amps $100.00 2 601 amps to 1000 amps $130.00 ~ 2 Over 1000 amps or volts $300.00 2 Reconnect only $40.00 ~ 2 C. Temporary Services/Feeders Installation, Alteration, or Relocation 200 amps or less $35.00 ~ 2 201 amps to 400 amps $40.00 ~ 2 401 amps to 600 amps $80.00 ~ 2 Over 600 amps or 1000 volts see "B" above D. Branch Circuits New, Alteration, or Extension Per Panel a) The fee for branch circuits with purchase of service or feeder fee · lEach branch circuit 5 1 $2.00 b) The fee for branch circuts without purchase of service or feeder fee First branch circuit $35.00 Each additional branch circuit $2.00 E. Miscellaneous (Service or Feeder Not Included) Each pump or irrigation circle $40.00 Each sign or outline lighting $40.00 Signal circuit(s) or a Emited energy panel, alteration or extension $40.00 F. Each additional Inspection over the allowable in any of the above, per Inspection $35.00 G. Minor Installation Labels Pack of 10 labels @ $5.00 each $50.00 (sold only to electrical contractors) H. Other (As required by Building Official) 102 2 ~2 5. FEES Al. Enter total of fees from Sec. #4 A2. Add 5% surcharge (.05 x Al) Subtotal B. Enter 25% of line A 1 for Plan Review (Sec. 3), if required C. Investigationl:ee (if required) D. Reinspection Fee ($25.00) TOTAL AMOUNT DUE Receipt No. 152 $ $ /. h0 $ $ 159.60