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IFOR CITY VALIDATION{ <br /> Received by: <br /> Dato: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT ~: <br /> Salem, OR 97301 <br /> <br /> Date: <br />24 hr. Inspe~tian Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 Issued by: <br /> <br />IELECTRICAL PERMIT APPLICATION ~ <br />Please complete all Sections, I through 5 L~L~[ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PA, <br /> <br />PERMITS ARE NON-TRANSFERABLE AND F~XPIRE IF WOP,~ IS NOT <br />STARTED '~/THIN 180 DAYS OF ISSUANCE OR IF <br /> WORK I$ SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> FOR OWHBR INSTALLATIONS <br /> <br />l'mperty Owner (ples~ palm) <br /> <br />klnilia~ A~d~s I Phone <br /> <br />I City/State/Zip <br /> <br /> Owner's Signature: <br /> <br /> 3. PLAN REVIEW $~CTION <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 /> 4. FEE SCHEDULE (Complete and ent~ ~otal ia A1 below) <br /> <br /> A. Realdential Pe~ Unlt Humb~r °f lnaPe~ti°na Pe~ Penlnit ale°wed --7 <br /> Service Included: ltam~ Coat (each) Sum I <br />tO00 ~q, ft. or I~ss $85.00 4 <br />Cch additional 500 aq. ft. <br /> o~ portion thereof $15.00 <br /> Limlt~d Eaerg'y $~.0.00 <br /> Each Manufactmzd Homa or Modular <br /> Dwelling Service or Feeder $40.00 2 <br /> <br /> B. ~vi~ ~ P~l~r s (Do~ not ia¢lud~ branch cir~uita, ~ s~tion D) <br /> <br />201 amps to 400 umps $60.00 <br />601 amps to 1000 ~ap~ $130.00 <br /> <br /> 200 ~npa or ies~ $35.00 <br /> 401 amp~ to 600 amps $80.00 <br /> <br />$35.00 -- <br />$ 2.00 <br /> <br />E. Mileelllne~li (Sa'vie~ at- E~gla' Nol ~ud~) <br />~ch pump or i~gation civic ~.~ 2 <br />~ch si~ or outline ~t~g ~,~ 2 <br />S~al c~uiffs) or a limited en~ <br />panel, alt~ or exte~i~ ~.~ <br /> <br />~rthe allowable in any of~e <br />a~, per ~pect~n $35 <br />O. Mia~ Inhalation ~bels <br />Pack of l0 labds ~ $5.~ ~eh $~.~ <br /> <br /> (~ req~wd by ~ildi~ <br /> A~ra ~elling El~cal F~ sq. <br /> ~dllng Fe~it ~bel g of ~ls ~C <br /> <br />5. FEES <br />Al. Enter totaloff~es from Sec.//4 $ <br />3,2, Add 5% sumharge (.05 x Al) <br /> ~ubtotal $.~ <br /> <br />B. Enter 25% of line Al for Plan Review <br />(Sec. 3), if required $.__ <br />C. Investigation Fee (ifrequlred) $.__ <br />D. Reieapcction Fee ($25.00) $ <br /> TOTAL AMOUNT DU~ $ ~ ~'~, ~ <br />Receipt No. <br /> <br /> <br />