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MARION COUNTY BUILDING INSPECT <br /> <br /> 285 Church St NE · Room 132 I · <br /> <br /> S~em, OR 97301 ~1~. <br /> <br /> Dato: ~$~10~ <br /> 24 hr. Inspection Line 373-4427 <br /> Office: Phone 588-5147 8:00am - 4:30pm <br /> FAX: 58~7948 ISSU~ by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK 1S NOT <br />STARTE~ ~ 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Mailing Address <br />Property Owner I Phone <br />Contractor's License No. <br />Contraetor'~ Board Reg. No. [ Job No. <br />Signature of Supervising Electrician <br /> <br />2B. FOR OWN'~R INSTALLATIONS <br /> <br />MailingAddresa PO. ,~O..~ 3,~5 IPh°ne 7 ./5/7 <br /> <br />Owner's Signal ~ <br /> <br />3. PLAN RBVIBW SBCTION <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 apphcation. <br /> <br />MC 15-341/96 <br /> <br />4. FEB SCItt~DULB (Complete and enter total in Al below) <br /> Number of Inspections per permit allowed -~ <br />A. <br /> Residential <br /> Unit <br /> Service Included: Items Cost (each) Sum l <br /> 1000 sq. ft. or less $85.00 4 <br /> Each additional 5~0 sq. fL <br /> <br /> Installation, filte~ation or Relocation <br /> 200 amt~ or less $50.00 -- 2 <br /> 201 amps Io 400 amps $60,00 -- 2 <br /> 401 aml~ to 600 amps $100.00 -- 2 <br /> 601 mnps to 1000 amps $130.00 -- 2 <br /> Over 1000 amps or voll~ $300.00 -- 2 <br /> Reconnect only $40.00 -- 2 <br /> <br />C. Temporary Services/Feeders <br />Installation. Alteration, or Rdo~ation <br />200 amps or less $35.00 -- 2 <br />201 amps to 400 amp~ $40.00 2 <br />401 amps to 600 amps $80.00 2 <br /> <br /> gRr~hase of s~rvice of feeder <br /> <br />b) The fee for branch circuits wjglOut <br />pu rcha~e~o f_s err Lc e 9r fe ~_er~e e <br />Fimt bm~ch circuit ~ $35.~0 <br />Each additional brmlch circuit $ 2.00 <br /> <br />E. Miscellaneous (~vie~ o~ F~nnl~ N~ Included) <br /> Each pump or ~igatinn circle <br /> <br /> Signal circfftt(~) or a limited en~gy <br /> panel, altemlion or extemion <br />F. Each additional Ink.ion <br /> ~er the allowable in any of~e <br /> <br /> Pack of 10 lab*Is ~ $5.00 each <br /> (sold only to electrical contractors) <br />H. Oth~ <br /> (As required by Baildi~ O~tciaD <br /> Aurora Dwelling Eleclfieal F~ <br /> <br />$40.00 2 <br />$40,00 __-- 2 <br /> <br />$40.00 __2 <br /> <br />$35.00 -- <br />$50.00 -- <br /> <br /> sq. fi. x $.068 =__ <br />#ofLabels N/¢ <br /> <br />FEES <br /> Al. Enter total of fees from Sec.//4 <br /> A2. Add 5% surcharge (.05 x AD <br /> Subtotal <br /> <br /> (Sec. 3), if required ~e,~ ~ <br /> D. Reinspectinn Fee ($25.00) <br /> <br /> mou rr DuE <br /> <br />$ <br />$ <br /> <br /> <br />