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IFOR CITY VALIDATION[ <br /> Received by: <br /> Date: <br /> <br /> 24 hr. I[mpecUon Line 37~4427 <br />Or,ce: Phone ~88-5147 8:00am - 4:30pm <br />FAX: S88-7948 <br /> <br />MARION COUNTY BUILDING INSPHCTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Chinch St NE · Room 132 <br /> <br />ELECTRICAL PERMIT APPLICATION ] <br />Please complete all ~ections, I through 5 <br /> <br /> ~S A~ NON-~S~B~ ~ ~ ~ W~ IS N~ <br /> ST~ ~ 1 ~ DAYS OF ISSU~ ~ ~ <br /> WO~ 1S SUSP~D~ FOR l~ DAYS. <br /> <br />2B. FOR OWNER IlqffI'ALLATIONS <br /> <br />Pml~rty Owner (plea~ pdm) <br /> <br />Mailing Addre~ [ Phone <br /> <br />City/State/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANRBVIEW SECTION <br /> <br />Marion County does not req~ire a plan review. <br />We will provide plan review service ff you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br /> Issued Di~,HiUN UUUNIY <br /> <br />4. ~B~ ~H~(~p~e~d~t~e~l~Al bebw) <br /> N~b~ of ~t~ p~ ~it ~w~ ~ <br /> P~ <br /> Unit <br /> ~: ~ ~ (~h) S~ I <br /> <br />~ ~dit~ ~ ~q; ~. <br />~i~ ~ $20.~ 1 <br /> <br /> ~ell~ ~ic~ or ~ ~,~ -- 2 <br /> <br />D. ~ ~ ~w~ ~ mt ~el~ ~ch ci~ui~ ~ ~tbn D) <br /> <br /> iualtll~tion, Alt~&tkm er <br /> 200 amps or less <br /> <br /> R~ct only <br /> <br /> ~1 ~to~ <br /> <br />D. Bran~ C~ita <br /> <br /> a) ~e fee for b~ch c~ ~ <br /> <br />$60.00 -- 2 <br />$100.00 2 <br />$130.00 2 <br />$300.00 <br /> $4O.OO __2 <br /> <br />$35.00 __2 <br />~.~ 2 <br />$~.00 2 <br /> <br />$ 2,00 -- <br /> <br />$35.00 <br />$ 2.00 -- <br /> <br />$40.00 <br />$40.00 <br /> <br />$40.00 __2 <br /> <br />$35,00 <br /> <br />$50.00__ <br /> <br /> sq. fl. x $.068 =__ <br /># of Labels NIC <br /> <br />5. I~E8 <br /> Al, l~ter tolal of fees from Sec.//4 <br /> A2, Add5% surchnrge (.05 xAl) <br /> <br />Subtotal <br /> <br /> B. Enter 25% of lineAl for PInnReview <br /> (Sec. 3), if required <br /> <br />· C lnvea~a~mFoo(ifmquimd) ~ <br /> D, ~ ~ (~.~) <br /> <br /> ~T~ ~O~ D~ <br /> ~eeipt Nm <br /> <br />MC 15-341/96 <br /> <br /> <br />