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FOR CITY VALIDATION <br />Recei~exl 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 hn Inspection Line 373-4427 <br />Office: Phone 588-5147 S:05am - 4:30pm <br />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION I <br />Please complete all ,Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> pERMITS ARE NON-TRANSFERABLE AND EXPIP~ 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 />El~chqcal Contracto one <br /> <br />Contractor'a License No. <br /> <br />21t. FOR OWNBR INSTALLATIONS <br /> <br />P~perly Owner (pl~se print) <br /> <br />l~iling Addr~ I Phone <br />City/State, Zip <br />Owner's Signature: <br /> <br />3. PLAN RIIVIEW SECTION <br /> <br />Marion County does not requite 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 />PERMIT NO: <br /> <br />Date: <br /> <br /> ,. <br /> <br />4. F~ SCHF~DIJL~, (Complete and ente~ tolal i~ Al below) <br /> <br />10130 sq. fl. or less $85.00 ~ <br /> <br />B. Servlee~ or Feedeca (Does not includo btnnch circuits, see section D) <br /> Installation, Aherati~ o~ Rdoe~ti~ <br /> 200 amps or less / $50,00 .'~"~. ~ <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 1(300 amps or volts $300,00 2 <br /> R*eonne*t only $40.00 2 <br /> <br />C. Temporary Se~vices/Feede~a <br /> <br /> 2~ ~ or 1~ $35.~ 2 <br /> <br /> a) ~e fee f~ b~ch c~ui~ ~ <br /> ~c~se of s~ice of fcc~r fee <br /> ~ch ~nch c~uit $ 2,~ <br /> <br /> b) ~/~e fcc for branch circuits without <br /> purchase of service or feeder fee <br /> First branch circuit $35.00 <br /> Each additional br~nch circuit $ 2.00 <br /> <br />E. Miscellaneous (Service or Fi~de~ No~ Included) <br />~lch pump or inigation circle $40.00 <br />Each aign or outline lighting $40.00 <br />Signal circuit(s) or n limited energy <br />panel, alteration or ext0mion $40.00 <br />F. Each additional ln~p~iion <br />Over the allo~abl¢ i~ auy of lhe <br />above, per Inspection $35.00 <br />O. Min~ In~llation Labzls <br />Pack of 10 labels @ $5.00 each $50.00 <br /> <br /> (~ required by B~ildit~ <br /> Aurma Dwelling Electrical F~ ~q. fi. x $.068 = <br /> Dwelling Permit Label # of Labels <br /> <br />5. FEES <br /> Al. F-alter total of fees from Sec. #4 <br /> A2. Add 5% su~¢hat~ (.05 x At) <br /> S~btotal <br /> <br />B. En~r 25% of line Al for pla~ Review <br />(Sec. 3), if r~quired $.__ <br />C, lnvestigafion Fee (if required) $ <br />D. Reimpection Fee (~5.~) $.~ <br /> <br />Receipt No. <br /> <br /> <br />