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FOR CITY VALIDATIONI <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPRCTION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspection Linz: 588-7904 <br />Office: 588-5147 8:00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> P/ease complete ali Sections, I through 5 <br /> <br />l. LOCATION OF INSTALLATION <br /> <br />Din~ctinm <br /> <br />PIARMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT I <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNBR INSTALLATIONS <br /> <br />Properly Owner (p/e~s~ print) <br /> <br />Marion County does not require,~plan rev}~w. <br />We will provide plan review service if yofi complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />~t~ 15-34 12/94 <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE $CHEDULI~ (Complete and ent~r Iotal hz Al b~low) <br /> <br />1~ sq, fi. or le~ $85.~ 4 <br /> <br />L~ited E~y $20.~ 1 <br />~ch Manufactur~ Homo or Mo~lar <br />~elling ~ioe or ~ $40.~ 2 <br /> <br /> 200 amps or less <br /> 201 amps to 400 amps <br /> 401 amps to 600 amps <br /> 601 amps to 1000 amps <br /> Over 1000 amps or volts <br /> Reconnect only <br /> <br /> 200 amps or less <br /> 201 amps to 400 amps <br /> <br /> Each branch circuit <br /> <br /> First branch circuit <br />~ch ~adition~l brtnch <br /> <br /> $so.00 ~_2 <br />$60.00 2 <br />$100.00 2 <br />$130.00 2 <br />$300,00 2 <br />$40.00 -- 2 <br /> <br />$35.00 -- 2 <br />$40.00 2 <br />$80.00 -- 2 <br /> <br />$ Z00 2,¥ <br /> <br />$35.00 -- <br />$2.~ <br /> <br />$40.00 __2 <br />$40.00 2 <br /> <br />$40.00 -- 2 <br /> <br />$35.00 -- <br />$50.O0 <br /> <br />__.~. ~. x$.06 =__ <br /># of Labels N/C <br /> <br />5. FEES <br /> A 1. Enter total of fees from Sec, g4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> Subtetal <br /> <br /> B. Enter 25% of line A 1 for Plan Review <br /> (See. 3), if r~quired <br /> C. Investigation Fee (if required) <br /> D, Reinspec6on Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />$ 7~. <br />$ %. 70 <br /> <br />$ <br /> <br />$ 7 .?0 <br /> <br /> <br />