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FOR CITY VALIDATION Recalved by: Date: COMMUNITY DEVELOPMENT CENTER 285 Church St NE · Room 132 Salem, OR 97301 24 hr. Inspection Line 373-4427 Office: Phone 588-5147 8:00am - 4:30pm FAX: $88-7948 MARION COUNTY BUILDING INSPECTION Date: Issued by: IELECTRICAL PERMIT APPLICATION Please complete all Sections, I through I. LOCATION OF I~STALLATION Dim~tiom PF~Vl]TS ARE NON-TRANSFeRABLE AND I~Pll~ IF WORK IS HOT STARTI~ WITHIN 1~0 DAYS OF ISSUANCE OR IF WORK IS SUSPI~qDED FOR 180 DAYS. 2A. CONTRACTOR INSTALLATION ONLY Mailing Address ~ '"~X FOR OWHBR INSTALLATIONS Propmy Ovn~r (pl~s~ Mailinff Addr~s [ Pbone City/State/Zip Owacr's Signature: 3. PLANR~VIBW SECTION IMarion County does not require a Plan review. We will provide plan review service if you complete Seetiun 5B and submit two (2) sets of plans and specifications with this application. MC 15-$41/96 4. FEE ~HEDULE (Complete and ent~ total in A1 below) N~mber of lrmp~ctinnf pe~ pen~it allow~ --~ A. Residential Unit Secvieeinoinded: Items C~st(each) Sum I 1000 sq. fl. O~ less $85.00 ..... 4 Each additiotm1500 sq. ft. ~ portion thereof $15.00 Limit~l Reers~ $20.00 Ee~ MMmfactured H~n~ or Modular Dwelling S~rvie~ or Fe~lcr $40.00 B. Services oF Feeders (Does not include branch circuits, see s~tion D) 200 amps or 1~ // $50.00 ~ 2 ~01 amp~to400ampn $60.00 , , 2 ~01 amps to 1000 amps $1~0.00 2 Over 1000 amps or volts $300.00 2 Reconnect only $40.00 2 200 amps or less 201 amps to 400 amps M0.00 2 401 amps to 600 amps $80.00 2 a) The lee for b~anch ~imui~, EaCh brnnch circuil ~ach additional brmch circuit $35.00 E. Miseellaneeas (Sm'vie~ ~ Feede~ N~ Inehd~d) Each pump or irrigation circle M0.00 2 Each aign or outline lighting $40.00 2 Sigual c~uit(s) ora t~mi~d energy panel, alt ~ation or extemion $40.00 2 ~. Bae,h additional intpe~ion Over the allowable in any of the above, per Inspection $35.00 O. Min~ Ioat~tlintio~t Labeta Pack of 10 labels · :$5.00 each $50.00 (sold only to electrical contractors) H. Othe~ (As requi~ed by B~ilditlg O~c/M9 Aurora Dwelling Electrical Fee sq. fl. x $.068 Dwelling Permit Label # of Lid~ls. NIC Al. £nt~r total of fec~i~om $~. #4 A2. Add 5% ~t~h~r~ (.05 x A 1) Subtotal B. Eutet 25% of Yme Al for Plan Review (Sec. 3), if required C. Investigation Fee (if required) D. Reinspection Fee ($25.00) TOTAL AMOUNT DU~ Receipt No.