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FOR CITY VALIDATION[ <br />R~ooived by: <br />Dato: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 <br /> P~P. Mff NO: <br /> <br />Salem, OR 97301 <br /> <br /> 24 hr. Inspection Uae 373-4427 <br />Office: Phone 58~.5147 8:00am - 4:30pm <br />FAX: 588~7948 <br /> <br />ELECTRICAL PERMIT APPLICATION [ <br />Please complete all Sections, I through 5 <br /> I <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Di~aiom <br /> <br /> I~P-MITS ARE NON-TRANSFERABLE AND F, xPmE IF WORK IS NOT <br /> STARTED ~ 180 DAYS OF ISSUAHCE OR IF <br /> WORK IS SUSI~IqDED FOR I ~0 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION OHLY <br /> <br />l~op~ny Ownor [ Phone <br /> <br />liB. FOR OWNER INST,&LLATIONS <br />Prop~y Owner (plo~ prim) <br /> <br />Ma!lin~ Addr~s <br /> <br />clty/sta~p <br /> <br />O~er's SignaR,re: <br /> <br />J pho~c <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br /> Mm'ion County does not require a plan review. <br /> We .will provide plan review service if you complete <br /> Seclion SB and submit two (2) sets of plans and <br />, sPeCifications with this application <br />MC 15.341196 <br /> <br />Issued by: <br /> <br />4. ]t]~]~ SCH]]DUL~ (Complet~ and onter total in A 1 b~tow) <br /> Numb~ of lnsp~fions p~r pstmit allowed <br />A. <br /> Residential <br /> Par <br /> Unit <br /> ! <br /> ~vlem Included: Itmm boat(each) Sum <br />lO00 sq. ft, er I~s $85.00 4 <br />Each additiomfl 500 sq, ft. <br /> ~ potlion 1hereof $15.(]0 <br /> <br />Each Manufactured Home or Modular <br /> <br />B. 8e~viees oc Feed~a (Doez not includu branch ~i~) <br /> lnstaEa tion, AIt~atioa ~ Rek~tion t ~ <br /> 200 amps or le~ ~ $50.00 2 <br /> <br /> 201 amps to 400 amps $~0.00 2 <br /> 401 amps to 600 amps $100,00 2 <br /> 601 amps to 1000 amp~ $130.00 2 <br /> Over 1000 amps or volta $300.00 2 <br /> R~onneet only $40.00 2 <br /> <br /> C. Temp~rnry <br /> Installation. Alteration, ~ Reloont|on <br /> 200 amt~ or less $35.00 2 <br /> <br /> D. Eaaneh Cireuits <br /> Nmv, Alt~ratlons, or Ext~nslon Pm~ Panel <br /> a) The fee f~c branch elteuits with <br /> ourchnse of service of feeder fee <br /> Each branch circuit $ 2.00 <br /> <br /> b) The fee for branch cimuits without <br /> <br /> Ftrst In-anch circuit $35.00 <br /> Each ad0fitional br-~mch circuit $ 2.00 <br /> <br />E. MJm~llaneous (gm-viom er Feede~ Not Included) <br />Each pump or htigation circle $40,00 2 <br />Etch sign or outlin~ lighting $40,00 2 <br />Signal circuit(s) or a limited energy <br />panel, alteration or extension $40.00 2 <br />F. ~ additional Inapeetlon <br />Over the nllowable in any of the <br />above, per Inspection $35.00 <br />O. Minc~ Installation Labels <br />Pack of l0 labels ~ $5,00 each $50.00 <br />(sold only to eleetti~t l eomraetors) <br />H. Other <br /> <br /> AUrOra Dwelling El~tncal Fee sq. fl, x $.068 <br /> Dwelling Pennit Label # of Labels <br /> <br /> <br />