Laserfiche WebLink
FOR CITY VALIDATION <br />Received by: <br /> <br />MARION COUNTY BUILDING INSPN_,CTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church Si NE · Room 132 <br /> Salem, OR 97301 <br /> <br />Date: <br /> ~ , t / ~ .Office: Phone 588-5147 <br />ELECTR{CAL PERMITAPPLICAT{ON [ ~)1 -I <br />Please complete all ~ections, I through_ t~ ,..~,. r_~v~,~.~4 o~ <br />1 Loc^nON ov I.Sr* LATION V <br /> ~ ~ <br /> <br />PERMIT NO: <br /> <br />Date: <br /> , <br /> <br />Issued by: <br /> <br />24 hr. Inspection Line 373-4427 <br /> <br /> 4. FBlq SCHBDULB (Complete and eater to~al in A 1 ~low) <br /> A, Re~idemial Per Unit Nmnber of Inspections per pe.,/~.llowed~ --[ <br /> <br /> pERMITS ARE NON-TRANSNERABLE AND EXPIRE IF WORK IS NOT [ <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />ElectricaIContracmr ~ p 7-e ~_L <br /> <br />2B. FOR OWNILR INSTALLATIONS <br /> <br />Property Ow~r (pleasopri~) <br /> <br />Mailing Address [ Phone <br /> <br /> Installation, Alteration ~ Relocation <br /> 200 amps or less $~0,00 -- <br /> 201 ampsto400 azaps $60,00 __ <br /> 401 amps to 600 amps $100.00 -- <br /> 601ampsto 1000amps $130.00 -- <br /> Over 1000 amps or volts $300.00 <br /> Reconnect only S40.00 -- <br /> <br /> 200 amps or les* $35.00 <br /> 201 amps to 400 amps $40.00 -- <br /> 401 amps lo 600 amps $80.00 -- <br /> Over 600 amps or 1000 rolls <br /> <br />D. Brsnch Circuits <br />a) The fee for bnmeh circuits ~ <br />Each branch circuit $ 2.00 -- <br />D The tee for b~neh eit~euits without <br /> <br /> First bnmeh circuit $35.00 -- <br /> Each additional branch oircuit $ 2.00 <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />E. Miscellaneous (Servieeor peede~ Not Included) <br />Each pump or irrigation circle :M0.00 __ 2 <br />Each sign or outline lighting $40.00 -- 2 <br /> Signal circuil(s) or a limited energy <br /> ! <br /> <br /> (As required by t~ildi~ Official) <br /> <br />$35.00 -- <br />$50.00 -- <br /> <br /> sq. fl. x $.068 <br />#ofLabels <br /> <br />N/C <br /> <br />FEES <br />Al. Enter tolul of fees fwm Sec. #4 <br />A2. Add 5% surcharge (.05 x Al) $___ <br /> Subtotal $.__ <br /> <br />B. Enter 25% of line Al for Plan Review <br />(See. 3), if required $___ <br />C. Investigation Fee (ifrequlred) $___ <br />D. Reinspeetion Fee ($25.00) $.__ <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br />City/~tate/Zip <br /> <br />Owner's Signntm'e: <br /> <br />3. PLANRBVIBW 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 application. <br /> <br />MC 15-341/96 <br /> <br /> <br />