ELEC - 1392471 - Laserfiche WebLink

Home Browse Search

FOR CITY VALIDATION Received by: Date: COMMUNITY DEVELOPMENT CENTER 285 Church St NE' Room 132 Salem, OR 97301 Date: Office: 588-5147 8:~ a.m. - 4:30p.m. F~: 588-7948 ISSU~ ELECTRICAL PERMIT APPLICATION Please complete all Sections, I through 5 1. LOCATION OF INSTALLATION DATE; 5-21-96 Job Address 1~,1~ ~o MILL CREEK BRIDGE-NW CORNER City DO~/k. LD Cross st. AIRPORT RD Directions BRIDGEf AT THE CORNER OF EHLEN RD ~ AIRPORT RD - SEE ATTACHED MAP r~cdption 200A SERVICE FOR TRAFFIC SIGNAL PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS. 2A. CONTRACTOR INSTALLATION ONLY Electrical C°ntract°rl/l'~]'C0 ELEC CO. Phone 926-4266 Mailing Address PO BOX 925, ALBANY, OR 97321 Properly Owner 0DOT Phone Contractor's License No. 22-15C Contractor's Board Reg. No. 49737 Job No. 61660 Supervisor's License No. 3257S -Ph°ne926-4266 2B. FOR OWNER INSTALLATIONS Property Owner (please print) Mailing Address Phone City/State/Zip Owner's Signature: 3. PLAN REVIEW SECTION Marion 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. 4. FEE SCHEDULE (Complete and enter total in A 1 below) Nulnber of Inspections per permit allowed A. Residential Per Unit ~ Service Included: 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 Each Manufactured Home or Modular Dwelling Service or Feeder $40.00 ~ 2 Services or Feeders (Does not include branch cimuits, see section D) Installation, Alteration or Relocation I 50.0~ 200 amps or less $50.00 201 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 "a" above D. Branch Circuits New, Alterations, or Extension Per Panel a) The fee for branch circuits w_j!h purchase of servi¢~ of feeder f,#& Each branch circuit 2 $ 2.00 4.00 b) The fee for branch cimuits without purchase of service or feeder fee First branch circuit Each additional branch circuit $35.00 __ $ 2.00 __ E. Miscellaneous (Service or Feeder Not Included) Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 Signal circuit(s) or a limited energy panel, alteration or extension $40.00 __ 2 F. Each additional Inspection Over thc 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 Oll~ciaO Aurora Dwelling Electrical Fee Dwelling Permit Label # of Labels N/C __eq. ll. x $.06 =__ 5. FEES Al. Enter total of fees from Sec. #4 $ 54,00 A2. Add 5% surcharge (.05 x A 1) $ ?. _ 70 Subtotal $.__ B. Enter 25% of line A 1 for Plan Review (Sec. 3), if required $.__ C. lnvestigalion Fee (if required) $.~ D. Reinspection Fee ($25.00) $.~ TOTAL AMOUNT DUE $ 56.70 Receipt No. MC 15-34 12/94