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FOR CITY VALIDATION <br />Recelvedby: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: ~8-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete al~ Sectione, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />~eetlons <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Pmpe~y Owner O/easepdt~) <br /> <br />Muiling Address I Phone <br />City/S late4Zip <br />Owner's Signature: <br /> <br />3. PLANREVIEW SBCTION <br /> <br />JMariun 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 wihh this application. <br /> <br /> MC 15-341/96 <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> Installation, Alt m'ati~ ~' Reloe~tlon <br /> 200 ~ or lena $50.00 2 <br /> 201 stmpa to 400 amps $60.00 2 <br /> 401 amps to 600 amt~ $100.00 2 <br /> ~01 amps to 1000 amps $130.00 2 <br /> Over 1~00 amps or vnlt~ $~0.00 2 <br /> Reconnect only $40.00 2 <br /> <br />C. Tempm'ary Service~/Peede~a <br />Installation, Alteration, ~ Relooation <br />200 amps or le~ $35.00 2 <br />201 amps to 400 ampe $40.00 2 <br />401 amps to 600 amps $80.00 2 <br />Over 600 amps or 1000 ~n)lts <br /> <br />D. ~'anch Citcu~.~ <br /> Nmv, Alterations, or B~tanslon Per Panel <br /> a) The fee for branch circuits wi~ <br /> <br /> Each branch ch*cult $ 2.00 <br /> <br /> b) The tee for branch circuits without <br /> <br /> Ftt~t branch circuit $35.00 <br /> Each addilio~al bnmch c~ult $ 2.00 <br /> <br />E. Ml~uilaneous (Servi~ zr Feeder Net Included) <br />Each pump or inlsetlon circle $40.00 2 <br />Each si~n or outline Ii,flag $40.00 2 <br />Signal circuit(a) ora limited energy <br />pa~el, atteratioa or ex~r~io~ ~0.00 2 <br />tt. Each eddltional lnapeotion <br />Over the allowable in any of thc <br /> above, per Inapection . $35.00 <br />O. Minc~ Inatallat'~a Labd~ <br />Pack of 10 labela @ $5.00 each $50.00 <br />(sold only to electrical contractorO <br />H. Other <br />(As required by Building O~tcial) <br />Aurora Dwelling Electrical Fcc __sq. fi. x $.068 =__ <br /> Dwelling Permit Label # of Laboln. NIC <br /> <br />Al. Entel Iotal of fees ~mm Sec. ~4 <br />32. Add 5% surcbo~ge (.05 x Al) <br /> Subtotal <br /> <br />B. Buter25% ofliacAl for Plan Review <br />(Sac. 3), if tcqnl~d $ -- <br />C. Investigatlon F~e 0 f r~luired) $__ <br />D. R~inspect/on Fee ($25.00) <br /> <br />R~ceipt No. <br /> <br /> <br />