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24 Hr lnaim~.tion Line: 588-7904 <br />Office: 588-5147 $:00a.m.-4:3Opan. <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />· LOCATION OF INSTALLATION <br /> <br />PERMITS AR~ NON-TRANSI=EP. ABLE AND ~ lF WORK lS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />Mailing Address <br /> <br />liB. FOR OWNER INSTALLATION~ <br /> <br />3. PLAN REVIEW 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 />~ 15-34 12'94 <br /> <br />285 Church St NE · Room 132 <br />Salem, OR 97301 <br /> <br /> I~u~ b~UN <br /> MARION ~U~TY <br /> <br /> Unit <br /> ~ Include: <br /> <br /> ~ch ed~tio~ 5~ ~. n. <br /> ~ ~on ~e~[ $15.~ <br /> ~mited E~y $20,~ ,1 <br /> ~ Ma~fac~ Home or Modul~ <br /> <br /> B. ~vi~es ~ F~e ~ not ~de b~ch ~i~ui~ s~ sect~n D) <br /> <br /> ~nn~t only ~.~ <br /> <br /> 2~ ~ or I~ $35.~ <br /> ~1 amps to ~ ~p~ ~.~ 2 <br /> <br /> D. ~an~ <br /> <br />b) The fee fo: branch circuits without <br /> purchase of service or feeder fee <br />First branch circuit <br />Each additional bttmch circuit <br /> <br />$35.~ <br />$2.~ <br /> <br />A 1. Eater ~otal of t~es from Sec. t~4 $ <br />A2. Add 5% su~ (.05 x Al) $. ~ O0 <br /> ~bt~al $.~ <br /> <br />B. ~r 25% of line Al for Phn Renew <br /> (Sec. 3), if ~quimd $.~ <br />C. l~esfigation ~e (if ~qui~d) $.~ <br />D. R~im~6on Fee (~5.~) $.~ <br /> <br /> Receipt No. <br /> <br /> <br />