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MARION COUNTY BUILDING INSPRCTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Chuwh St <br /> S~em, OR 97301 <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete ~1 ~ctions, I through 5J 4. ~B ~H~ <br /> <br />FOR CITY VALIDATION <br />Received by:. <br />Date: <br /> <br />I. LOCATION OF INSTALLATION <br /> <br />PER IvHTS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS N~"~ <br /> STARTED 'ATrlIlN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Electrical Contractor _~J,~ ~__~~ <br />Mailing Address ~7__~ <br />Property Owner ~ t Phone <br />Contmctor's~ <br /> <br />2B. FOR OWNER I~STALLATIONS <br />l~°pertyOwner(ple~se~ri~)~%~2~t° %~ <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 />MC t5-34 12./94 <br /> <br /> Number of Inspections p~r pennil allowed -~ <br />A. <br /> Residential <br /> Per <br /> Unit <br /> 8ervie*lnelud~d: llems Cost(each) Sum I <br /> 1000 sq. fl. or leto $85.00 4 <br /> Each addiliona1500 sq. fl. <br /> e¢ portion Ihe~of $15.00 <br /> Linfited Enemy $20.00 I <br /> Each Manufacmeed Home or Moddlar <br /> DweltingS~rvieeocFe*d~ ~ . ,, $40.00 2 <br /> <br />B. S~vlea~ o~ F~d~s (Does not includ* branch circuits, see section D) <br /> Installation, Alteration ~ Reloe, ati~n <br /> 200 an~ o~ less $50.00 __2 <br /> 201 amps to 400 amps $60.00 2 <br /> 401 amps to 600 amps $100.00 2 <br /> 601 amps to 1000 amps $130.00 2 <br /> Over 10~0 aml~ or volts $300.00 - 2 <br /> Reconnect only $40.00 -- 2 <br /> <br />C. T~np~a~ary l~rviee~Feede~s <br /> <br /> 401 mnps to 600 amps $80.00. 2 <br /> <br /> a) The fee for branch cheui~ ~ <br /> Ea~.h branch cireult $ 2.00 <br /> <br />b) lhe tee for branch cieeuit~ without <br /> <br />First branch cim uit <br />Each additional branch circuit <br /> <br />$35.00 <br />$ 2.00 <br /> <br />]g. Miscellaneous (Service ~t F~de~ Not ~d~) <br />~h prop ~ i~gat~ e~le ~.~ 2 <br />~h si~ oro~e ~ ~.~ -- 2 <br />Signal c~uit(s) 0r a limited ener~ <br />panel, alt~ti~ or ex~m~ ~.~ ~ 2 <br />P. ~ addgi~l l~n <br />~ t~ all~bb in ~y of ~e <br /> <br />O. Min~ ln~alhtlon ~b~ <br /> Pack of 10 labels ~ $5.~ ~ch $~.~ ~ <br /> <br />$. FI~ES Al. Enter total of tees from Sec./t4 <br /> A2. Add 5% sumhnrgc (.05 x Al) <br /> <br />~obtotal <br /> <br />B. Emer 25% of line A 1 for Plan Review <br />(Sec. 3). if required $ __ <br />C. Investigation Fee (if mqulred) $ -- <br />D. Reinspection Fee ($25.00) $__ <br /> <br /> · rOTAt. <br />Receipt No. <br /> <br /> <br />