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FOR CITY VALIDATION[ <br />Received by: <br />Date: <br /> <br />IELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />L LOCATION OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVEL~O?MENT CENTER <br /> <br /> ~ Hr In -' n L~ 58~~ D~O: <br /> <br />~obAdd~ <br /> <br />City <br /> <br />Dkeclions <br /> <br />Cross SL <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WI THiN 180 DAYS OF ISSUANCE OR 1F <br /> I <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />~. :2A~ CONTRACTOR INSTALLATION ONLY <br /> Electrical Contractor~'?/~_~/-~.. f Phoue ~ <br /> <br />Pwperly Owner ~ [ ~r t ~-- I Phone <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />P~perty Owner (please prim) <br /> <br />Mailing Address I Phone <br /> <br /> City/State/Zip <br /> <br /> Owner's Signature: <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 fib and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-34 12/94 <br /> <br />4. ~E SCH~J)UL~ (Comple~ and enter total in A1 below) <br /> Number of Inspections per pemfit ui]owed ~ <br />A. Re~id~nthl Pe~ Unit ~ <br />Service Inoluded: ~'Itcmn Coat (each) Sum I <br />1000 ~q. fl. or less t ~N,"~I $85,00 4 <br />Each additional 500 sq. fl. \~ ~ <br /> or portion therefor' \ ~/ $15.00 <br />Limited Energy \~" ~' $20.00 1 <br />Each Manufactured Home or Modular <br />Dwelling Service or Fee~er $40.00 2 <br /> <br />n. Earviees or Feeder~ (Doe~ not include brnnch elr~uits, see section D) <br /> <br /> 200 sm~ or ~ss $50.00 <br /> 2 <br /> 201 nml~ to 400 amps t ~0.00 ~-~ff~ <br /> <br /> ~01 amps ~o 1000 mnp~ $1~0.00 2 <br /> <br /> 200 amps or le~ :~5.00 2 <br /> <br /> a) The fee for br~nch circuits ~ <br /> En~:h b~nch¢ircuit /o $ 2.00 ,~O~'~ <br /> <br />b) The fee for branch ¢imui~ wilhout <br /> purchase of service or feeder fee <br />First brnnch circuit <br />Each additional branch circuit <br /> <br />E. Misedlaneous (Servlceor Feeder N~ Included) <br /> Each pump or irrigation circle <br /> Each sign or cutline lighting <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension <br />F. Each additional Inape~tion <br /> Over thc allowable in any of Ihe <br /> <br /> Pnch of 10 labels @ $5.00 each <br /> <br />$35.110 <br />$ 2.O0 -- <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br /> sq. ~ x~OO =__ <br />#ofLa~ls N/C <br /> <br />A2. Add 5% sut~har~ (.05 x Al) <br /> <br /> (Sec. 3), if required <br /> <br />D. Reioapection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />