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FOR CITY VALIDATION <br />Received by:. <br />])ate: <br /> <br />IELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through <br /> <br />MARION COUNTY BUILDING INSPI~-CTI~.! <br /> <br /> Salem OR ~1~01 .... "~:~ <br /> 24 hr. [nspe~inn Line 3734427 Date: ~ <br /> ~ce: Phone ~8-5147 8:00am- 4:30pm BUILDING <br /> F~: 5~-7948 Issu~ by:~ <br /> <br /> PI~Jv~TS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTF.~ WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPI~qDED FOR 180 DAYS. <br /> <br /> ~ONTR~CTOR ~I'ffrALI~TION ONLY <br />Electrical Contractor <br /> [:hone <br /> <br />Mailing Address <br /> <br />l~x~perty Owner I ~e <br />Con~aclor's License No. <br />O~lltlctor's Itoard R~g. 1~o. I Job No. <br /> <br />Signature of SugcrvislnS ElccUicinn <br /> <br /> i <br />Supervisor's License No. Ph~me <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 />4. FEll SCHllDULR (Complete and enter total in A t below) <br /> Number of lnspection~ per p~rmit allowed -~ <br /> R~idential <br /> Unit <br /> Service Included: Items Co~t (each) Sum I <br /> 1000 sq. fl. 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 /> <br />B. Se~vico* or F~I~ s (Docs not include branch circuits, se~ section D) <br /> Installation, AIt~ation or Rdoeatima <br /> 200 amps or Icsa $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 1000 amps or volta $300.00 -- 2 <br /> Reconnect only $40.00 -- 2 <br /> <br /> In~t allatinn, Aher atica, cc Raloent tion <br /> 200 amps or less $35.00 -- 2 <br /> 201 amps to 400 amps $40.00 -- 2 <br /> 401 amps to 600 amps $80.00 __2 <br /> Over 600 amps or 1000 volls <br /> <br />D. Branch Circuits <br />N~w, Ah~'ationa, or Extension P~ Panel <br />a) The fee for branch circuits ~ <br />purchase of service of feeder fee <br />Each branch circuit $ 2.00 -- <br /> <br />b) Thc fee for branch circuits ~ <br /> ourchase o f scrvic~&cLf~ <br />First branch eh, cult <br />Each additional branch circuit <br /> <br />E. Mia~elluneous (,%rviceor P~t*r N~ Included) <br /> <br /> ~ch si~ or curiae li~g <br /> S~ c~t(s) or a limited ~ <br /> <br />F. ~ch edditio~l l~p~i~ <br /> ~er ~e allowable in any of ~e <br /> <br /> ~ Pack of 10 I~els ~ $5.~ ~ch <br /> <br />H. ~h~ <br /> <br /> A~ra ~elling Elcc~cal F~ <br /> <br />$35.~ <br />$2.~ <br /> <br />$40.00 __2 <br />$4O.OO __2 <br /> <br />$40.00 -- 2 <br /> <br />$35.00 -- <br />$50.00 -- <br /> <br />--*{q. J~. X $,068 <br /># of Labels____ <br /> <br />5. FEES <br /> A 1. Enter lotal of fees from See, g4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> Subtotal <br /> <br /> B. Enter25% oflineAl for Plan Revinw <br /> (See. 3), if required <br /> C. Investigation Fee (ifrequi~:d) <br /> D. Reimpeetion Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Re~ipt No. <br /> <br />MC 15-341/96 <br /> <br /> <br />