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FOR CITY' VALIDATIONI P.e~eived by:. ~ Date: I MARION COUNTY BUILDING INSPBCTION COMMUNITY DEVELOPMENT CENTER 285 Church St NE · Room 132 Salem, OR 97301 ELECTRICAL PERMrT APPLICATION Please complete all Sections, I through 5 't. LOC ATION OF INSTALLATI Obl 24 Hr Insp~tion Li~e: 588-7904 Office: 588-5147 8:00a.m.-4:30p.m. FAX: 588-7948 I 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 Mailing Address I/ob No. Property Owner Contractor's License No. Conlraclor's Board Reg, No. Signal ur~ of Supervising Eloctrician FOR OWNER INSTALLATIONS ,77 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. MC 15-34 1~ PERMIT NO: Date: Issued by: 4. ~E SCH]~DUI.II (Complete and eota- tol~l in A1 below) Rmidentinl P~ Unit ~[nclud~: 1~ C~t(each) S~ i 1~ sq. fi. or less $85.~ 4 ~ nddit~n~ ~ sq. ft. or ~on ~e~f $15.~ Limited ~ $20.~ 1 ~ch Mnnofactu~ ~ome or M~ar ~ell~ ~ice or F~ed~ $40.~ 2 B. ~v~ ~ F~ ~s ~t ~clud* ~ch c~uit~ se~ section D) 2 2 2 2 2 .2 2 2 .2 $50.00 201 amps to 400 amtv~ $60.00 401 am~ to 600 ami~ $100.00 601 amps to 1000 amp~ $130.00 Over 1000 amps or volts $300.00 Ro~onnect only $40.00 C. Temporary ~h~'vi~/Fe~d~r! Installation, Alteration, er Relocation 200 amp~ or lena $35.00 201 amps to 4G0 aml~ $40.00 401 nmp~ to ~00 amp~ $80.00 Over 600 amps or 1000 vol~ ~ee 'B' above D. Branch Circuits New, Alterations, er Ext~nslon P~ panel a) The fee for branch ch~uita ~ F. aeh branch ~i~uit $ 2.00 b) The fe~ for bt~nch c'tvouit~ wilhem pumhase of service or fee. der fee First branch circuit $35.00 Each additional branch circuit $ 2.00 £. Mi~ellaneous (Servlc~- Feeder Not Ineluded) Each primp or ~ation ci~le ~.~ 2 ~ch si~ or outl~e li~g $~.~ 2 Si~al eirc~t(s) or a l~ited ~y ~nel, alt~ ~ ext~i~ $~.~ ~ 2 F. ~ additio~l l~ion ~er the all~ab[~ ~ any a~ve, ~r ~p~n $35.~ O. Min~ In~al~tinn ~ck of l0 labels ~ $5.~ ~ch $~.~ (~d only to e~trical co~ractors) H. 0~ (~ r~uirod by ~il~ OWwiaO A~ Dwelli~ ~l~cal F~ ~.~. ~etling P~R ~bel ~ of ~ls NIC FSES Al. Enter totalof fee~ from $~c. #4 $.__ A2. Add 5% surcbarg~ 605 x Al) $.~ Subtotal $ B. Enter 25% of llne A 1 for Plan Review (Sec. 3), if required $ C. lnvcsligafion P=e (if required) $ D. Reimpecfion Fee ($25.00) TOTAL AMOUNT DUB Receipt No.