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FOR CITY VALIDATION <br />Received by:__ <br />Date:__ <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete ail ~ectioas, I through 5 <br /> <br />COMMUNITY DEVELOPMENT CENTER ~ <br /> 285 Church St NE · Room 132 1 L~,~ ~ <br /> Salem, OR 97301 i[1¥, <br /> ~ Hr In~tion L~o: 58~7~ ~O: <br /> Offs: 588-5147 8:~ a.m. - 4:30 p.m. <br /> <br /> BUILDING <br /> <br />1. LOCATION OF INSTALLATION <br />lob Addr~ ~ <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WlTltlN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br />Elech%al Contracto~r ~ <br /> <br />21t. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (pleas~ pdnt) <br /> <br />Mailing Address I Phone <br /> <br /> City/State/Zip <br /> <br /> Owner's Signature: <br /> <br /> 3. PLANRBVIBW SECTION <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 />MU 15-fl4 12/94 <br /> <br />4. NIlE SCHEDULE (Complete and ent~ totalin Al below) <br />A. Residential Per Unit Nmnber of lnsw.,ctions per permit allowed---/ <br /> Service Included: ltema Cost (each) Su <br /> mt <br />1000 sq. ft. or less $85.00 4 <br />Each additional 5~0 zq. ft. <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. $~viee~ ~ Feeders (Does not include Inaneh circuits, see section D) <br /> Installation, Alteratima or Reineation <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 amps $130.00 __2 <br /> Over 1000 amps or veils $300.00 -- 2 <br /> Reconnect only $40.00 2 <br /> <br />C. Temporary SefvinedFeedera <br />Installation, Alteration, or Rdoeatlon <br />200 amps or leto $35.00 -- 2 <br />201 amps to 400 amps $40.00 -- 2 <br />401 amps to 600 amps $80.00 -- 2 <br />Over 600 amps or 1000 volts <br /> <br />D. Branch Circuits <br /> New, Alterationa, ~ Extension Pe~ Panel <br /> a) The fee for branch circuits with <br /> <br /> Each branch circuit <br /> <br />b) The fee for branch circuits ~ <br /> <br />First branch circuit <br />Each additional branch circuit <br /> <br /> 2.00 -- <br /> <br />$3s.oo~_CD <br /> ZOO __ <br /> <br />E. Miscellaneous (SerVice or Feeder Not Included) <br />Each pump or irrigation circle $40.00 <br />Each sign or outline lighting $40.00 <br />Signal circuit(s) or a lhnged energy <br />panel, alteration or extemion $40.00 <br />F. Each additional Inapeetlon <br />Over the allowable in any of the <br />above, per Inspection $35,00 <br />O. Minor Installation Lab*la <br />Pack of l0 labels @ $5.00 each $50.00 <br />(sold only to electrical contractors) <br />H. Other <br />(As reqvired by Building OfftciM) <br /> Aurora Dwelling Electrical Fee sq. 1/, x $.06 = <br /> Dwelling Permit Label # of Labels <br /> <br />Al. Enter total of legs from Sec.//4 <br />A2. Add 5% surcharge (.05 x A 1) <br /> Subtotal $. <br /> <br />B. Enter 25% of lineAl for Plan Review <br />(Sec. 3), if r*quired $. <br />C. Investigation Fee (if required) $. <br />D. Reinspeetion Fee ($25.00) $. <br /> TOTAL AMOUNT DUE $~..~ <br />Receipt No. <br /> <br /> <br />