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FOR CITY VALIDATION [ <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 Hr Inspection Line: 588-7904 <br /> Office:. 588-5147 8:00 a.m. - 4:30p.m. <br /> ~ FAX: 588-7948 Issued by: <br /> <br /> IRE SCHEDUL]~, (Complata and enter lotal m Al below) <br /> ~ ' ~- ~J t~y0 Nmnberoflnspectionsperpermitallowed-~-/ <br /> I A. Residential Fex Unit Items Co/;t (each) <br />I. LOCATION OF INSTALLATION~,' M]~ RI0P~/~.~/~n/,J~ ~'~ ]~._.:: Ser vice Included: <br />lobAddre~ 8500 GOLF CLUB ROAD $_0ILDING I.~. Fprt Each additional SOO sq. rt. <br /> <br />City AUMSVILLE lo-sst, tt~ 22 <br />Dimctions <br /> <br />Description SERVICE AT NE INTERSECTION OF <br /> BRIDGE <br /> <br />PERMITS ARE NON-TRANSFERABlE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />I <br />ElectricdiC°ntract°rLINNCO ELEC CO. ] Ph°ne926-4266 <br />~ili.gAd&~s PO BOX 925, ALBANY: OR 97321 <br /> <br /> Property Owner ODOT Phone <br /> Contractor's License No. 22-15C DATE: 8-13-96 <br /> Contractor's Board Reg. No. 49737 . <br /> <br /> Superviaor's License No. 3257S [ Ph°ne 926-4266 <br /> <br /> 2B. FOR OWNBR INSTALLATIONS <br /> <br /> PtoperOJ Owner (p/easeprint) <br /> Mailing Address [ Phone <br /> City/State/Zip <br /> Owner's Signature: <br /> <br /> 3. PLAN RBVIIRW aBCTION <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 15-34 12/94 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br /> b) The fee for branch circuits without <br /> 13g'chase of service or feeder fee <br /> Fit, st branch circuit <br /> Each additional branch circuit <br /> <br />E. Miscellaneous (8erviceor F~d~ Not Included) <br /> Each pump or irrigation circle <br /> Each sign or outline lighting <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension <br />F. Each additional Inspection <br /> Over the allowable in any of the <br /> above, per Inspection <br />O. Minor Installation Labels <br /> Pack of 10 labels @ $5.00 each <br /> (sold only to ¢lectricM contrscwrs) <br />H. Other <br /> (As required by B~ilding Oll~cial) <br /> Aulora Dwelling Electrical Fee <br /> Dwelling Permit Label <br /> <br />__.sq. #. x $.~6 <br />g of Labels <br /> <br />$35.~ <br />$2.~ <br /> <br />$40.00 -- 2 <br />$40.00 2 <br /> <br />$40.00 -- 2 <br /> <br />$35.00 -- <br />$50.00 -- <br /> <br />5, FEES <br /> A 1. Enter total of fees from Sec. #4 <br /> A2. Add 5% surcharge (.05 x A 1) <br /> Subtotal $ <br /> <br /> B. Eater 25% of line A 1 for Plan Review <br /> (Sec. 3), if re, qinred <br /> C. Investigation Fca (if required) $__ <br /> D, Ralnspection Fee ($25.00) $__ <br /> <br /> TOTAL AMOUNT DUE $, 58.80 <br /> Receipt No. <br /> <br /> 1000 sq, fi. or less $85.00 4 <br /> <br />or portion thereof $15.00 <br />Limited Energy $20.00 1 <br />Each Manufactured Home or Modular <br />Dwelling Service or Feeder $40.00 -- 2 <br /> <br />B. Services or Feeders (Ekes not include Ircaflch circuits, see s~ction D) <br /> Installation, Alteration o~ Relocation <br /> 200 amps or less 1 $50.O0 50.QO <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 1000 mnps or volts $300.00 -- 2 <br /> Reconnecl only $40.00 -- 2 <br /> <br /> Each branch circuit 3 $ zoo 6.00 <br /> <br /> <br />