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FOR CITY VALIDATION <br />Re~eived by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPRCTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <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 />IELECTRICAL PERMIT APPLICATION I <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />cig ~e4'v'o t ~' <br />Dir~tions <br /> <br />Icro~s St. <br /> <br />Description <br /> <br />PERIvgTS ARE NON-TRANSFERABLE AND EJ{pIRE IF WORK IS NOT <br /> I <br /> STARTED WITHIN 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 [ Phone <br /> <br />Contractor's License No. <br /> <br />Contractor's Board Reg. No. <br /> <br />lob No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />3. PLA_N'REVIEW SECTION <br /> <br />I 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 />PERMIT NO, -~~ <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCH~DUI.~ (Completoand enter lotalinAl below) <br /> R*~d~ntial <br /> <br /> 1000 sq. fi, or less $85.00 4 <br /> <br /> Installation, Alt~ation or Relocation j <br /> 200 amps or 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 araps $130.00 2 <br /> Over 1000 amps or volts $300.00 2 <br /> Reconnect only $40.00 2 <br /> <br />C. Temporary Servi~es/Feedora <br /> <br /> 200 amps or le~ $35.00 2 <br /> <br />b) Ti~e fe,~ for branch circuits without <br /> purchas~ of service or feeder fee <br />First branch circuit <br />Each additional branch circuit <br /> <br />$35.00 -- <br />$ 2,00 <br /> <br />E. Miscellaneous (~eevlae ~r Feeder Na Included) <br />Each pump or ~xigation circle $40.00 <br />Each sign or outline lighting $40.00 <br />Signal circuit(s) or a limited enexgy <br />panol, alteration or extemion $40.00 <br />F. Each additional inspection <br />Over the allowabl~ in any of <br />above, per Inspection $35.00 <br />O. Mino~ Inatallation Lchela <br />Pack of 10 labels @ $5.00 each $50.00 <br />(sold only to e lectdc~ I contractors) <br />H. Oth~ <br />(.4~ required by Building Olt{¢ial) <br /> Aurora Dwelling Bleetrical Fe~ ~q, fi. x $.068 <br /> Dwelling Pennit Label # of Labels <br /> <br />A2. Add 5% sumharg~ (.05 x Al) $.__ <br /> ~ubtotal $.__ <br /> <br />B. Enter 25% of lin~ Al for Plan Review <br />(Sec. 3), if requimd <br />C. Investigation Fee (if required) $.__ <br />D. Reinspeetion Fee ($25.00) $.__ <br /> <br /> TOTAL AMOUNT Dim $.__ <br /> <br />MC 15-34 1/96 <br /> <br /> <br />