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ELEC - 1455199
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ELEC - 1455199
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Entry Properties
Last modified
2/9/2013 1:55:27 PM
Creation date
7/21/2004 11:03:31 AM
Metadata
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Template:
Permits
Permit Address
12813 ARNDT RD NE
Permit City
Aurora
Permit Number
555-96-05439
Parcel Number
031W34 01800
Permit Type
ELEC
Permit Doc Type
Permit Document
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FOR CITY VAI JDATION] <br />Received by:. ~ <br />Date: [ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 285 Church St NE · Room 132 PERMff NO: <br /> <br />Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />~b^4~ 12813 Arndt Rd NE <br /> Aurora, OR 97002 Ic~s~Klupinger Rd <br /> <br />Directiom <br /> <br />PERMITS ARE NON-TRANS~ERABLE AND EXPIRE IF WORK IS N~T <br />STARTED ~TFHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPF~NDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Mailing Address <br />Property Owner [ Phone <br />Contractor's Liceuae No. <br />Contractor's Board Reg. No. I Job No. <br />Signature of Sut~rv~sing Electriei~ <br /> <br />Supervlsor's License No. I P~one <br /> <br />2B. FOR OWNBR INSTALLATIONS <br /> <br />l~ope~y Owner ~le~ prinO DO~ F~ccaci~ <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />IMarion 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 />MC 15-341/96 <br /> <br />Dine: <br /> <br />Issued by: <br /> <br />4. FEE SCH~[Tf-~ (Omlple~oandente~tolalinAl below) <br /> N~ber of ~6o~ p~ ~it allow~ ~ <br /> P~ <br /> Unit <br /> <br />1~ sq. fi, ~ less $85.~ 4 <br /> <br />~ch M~ufacm~ H~ or <br /> ~ice or F~cd~ ~,~ 2 <br /> <br /> ~1 amps to l~ps $1~,~ 2 <br /> R~ect only ~ 2 <br /> <br />D, Bran~ Ck~itn <br />n) ~e fee f~ ~ch c~uim ~ <br />~ ~nch cimult $ <br /> <br /> b) 'rne fee for branch circuits without <br /> <br /> Fkst branch cit~uit <br /> Each additional branch c~t <br /> <br /> ~ch pump or ~gat~n c~l~ <br /> ~ si~ or out~e li~t~g <br /> <br /> p~el, ~fi~ or exte~i~ <br /> <br /> ~er~e allowable ~ ~y <br /> <br />H. ~ <br /> <br />$35.00 -- <br />$ 2.O0 10.00 <br /> <br />Sa0110 2 <br />$40.00 -- 2 <br /> <br />$40.00 2 <br /> <br />$35.00 <br /> <br /> $q. fl. x $.068 =__ <br /># of Lab.h <br /> <br />N/C <br /> <br />5. PEES Al, Enl~r total of fees from Sec. fi4 <br /> A2. Add5% surcharge (.05 x Al) <br /> <br /> B. Enter 25% of llne A 1 for Plan ReVmw <br /> (Sec. 3), if requi~d <br /> C. Investigation Fee (if required) <br /> D. R~inap~ction Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />$ <br />$__ <br /> <br />$__ <br />$__ <br /> <br /> <br />
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