Laserfiche WebLink
Received by: <br />Date: <br /> <br />MARION CODNTY BUILDING INSPECTION <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: 59g-7948 <br /> <br />IELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIR~ IF WORK IS NOT <br />STARTED WITmN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INgrALLATION ONLY <br /> <br />Property Owner <br /> <br />Phon~ <br /> <br />211. FOR OWNBR INSTALLATIONS <br /> <br />Propeay Ova~r (pl~soprint) <br /> <br />Mailing Address I Phone <br /> <br />City/S ~a~./Zip <br /> <br />Owner's Signature: <br /> <br />3. PLAN REVItIW $1~CT1ON <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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. F~g[ ,~HriDUL]~ (Complet~ and ~nter totsl in Al below) <br /> Nmnber of Inspections per p~nnit allowed.~---~ <br />~L Residential P~r Unit <br /> <br />Each additiona~ 500 sq. fl. // ~'~ <br /> or portlonlhereof ~ ~ $15.00 <br />Limi~l Eaarg~ ,/ $20.00 <br />Each Manufactured Hom~ or Modular <br /> Dwelling Service or Feeder ~ $40.(10 -- 2 <br /> <br />B. Sa-vi~ or F~d~a (Doea not in¢ludu branch ci~uits, see section D) <br /> <br />200 amps or les~ ~ $50.00 ,,~_ 2 <br /> <br />601 amps to 10~0 amps $130.00 -- 2 <br />Over 1000 amps or volts $300.00 -- 2 <br />Reconnect only $40.00 2 <br /> <br /> 200 amps or I~ss $35.00 -- 2 <br /> <br /> gllr~alm~e~vico of feoder fe~ <br /> I <br /> <br />$35.~ <br />$2.~ <br /> <br />II. Miaoellafleoia (Sea-vioo ~r F~ler N~ ~lud~) <br />~ch pump ~ i~gat~n ci~le $~.~ 2 <br />~ch si~ or ouffmo li~l~g ~.~ ~ 2 <br />Sign~ circuits) or a l~it~ <br />p~cl, alt~ti~ or extemion $~,~ ~ 2 <br />F. Ea~ additional l~ion <br />Over ~e allowable in any of <br />~ve, pot ~pgtion <br /> <br />H, Oth~ <br /> (~ c~uired by Buil~ O~c~l) <br /> <br /> Dwelling Pe~it ~hal <br /> <br />FEB8 <br />At. Enler total of feea from Sec, #4 <br />A2. Add 5% surcharge (.05 x Al) <br /> ~ubtolal <br /> <br />B. Enter 25% of line Al for Plan Review <br /> (Sec. 3). if r~quired <br />C. Investigation Fee (if required) <br />D. R¢iaapectiott Fee ($25.(10) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br /> <br />