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I <br />FOR CITY VALIDATION [ <br />Received by:. <br />Date: <br /> <br /> OffO 6-oo0 <br />MARION COUNTY BUILDING INSPECTION <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 $:00am - 4:30pm <br />FAX: 588'/948 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />1. LO~ATION OF INSTALLATION <br /> <br />PEI~MIrS ARE NON-TRANSFERABLE AND EXPIRE IF WORK ]S NOT <br />STAR'I'FJ) ~ 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Address <br /> <br />phoneg ] Fax~ <br />Property Owner Phoneg <br /> <br />Supervisor's License No. <br /> <br />Job No. <br /> <br />Phone2 <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />:5. PLAN R~VIBW SBCTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section SB and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-34 1/96 <br /> <br />4. FEE SCHEDULE (Complete and oaler total in A[ below) <br /> <br />A. Residential Per UnitNmnbor of Inspections pet permit allowed -~ <br />S~'vleo Includ~l: lten~ Coat (each) S <br />1000 sq. fl. or less $85.00 4 <br />Each addhiona1500 sq. ft. <br /> or portion thereof $15.00 -- <br />Limited Energy $20.00 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feedex $40.00 2 <br /> <br />B. 8e~viooa or F~d~s (Does not in¢lud~ branch circuits, see section D) <br /> <br /> 200 amps or less ..'~ $50,00 -- <br /> 201 amps to 400 amps $60.00 <br /> 401 anaps to 600 amps $100,00 <br /> 601 amps to 1000 amps $130,00 -- <br /> Over 1000 amps or volts $300.00 -- <br /> Reconnect only $40.00 <br /> <br />C, Tempm'ary ~vlee~Feed~s <br />Installation, Ahe~ation, er Re[oeatlon <br />200 amps or less $35.00 -- <br />~01 amps to 400 amps $40.00 -- <br />40l amps to 600 amps $~0,00 <br />Over 600 amps or 1000 volts <br /> <br />D. Branch Cireulta <br /> <br /> a) The fee for branch circuits ~ <br /> p~ltchns e of service of feeder f~ <br /> Each branch circuit $ 2.00 -- <br /> <br /> Ftrst br~ach circuit $35.00 -- <br /> Each additional broach circuit $ 2.00 -- <br /> <br />B. Mi~elhneous (~'vico ~ Feed~ Nd ineludod) <br /> Each pump or ~ga~on eimlo ~.~ <br /> <br />Signal cimuit(s) or a l~i~d ~ <br />~net, alt~fi~ or ~t~ion ~,~ <br />F. ~ch additio~l i~ion <br />Over ~e allowable in any of ~* <br />~ve, per ~pectioa $35.00 <br /> <br /> Pack of 10 labels ~ $5.~ tach $50.~ <br /> <br /> (~ requirad by ~ildi~ O~tci~O <br /> Aumm DweWmg ~al F~ sq. ~. x $.068 - <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br />2 <br /> <br />2 <br />2 <br /> <br />2 <br /> <br />5. PRES <br /> Al. Enter tolal of fe~s from Sec. #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> SubWtal <br /> <br /> B. ~tor 25% of l~e A 1 for Plan Review <br /> (Sec. 3), if r~ui~d <br /> C. Investigalion Fee (if~u~d) <br /> D. Reimpect~n ~ ($25.~) <br /> <br /> TOT~ ~O~ <br /> <br /> <br />