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FOR CITY VALIDATIONI <br />R~:eive~l by:. [ <br />Date: ] <br /> <br />MARION COUNTY BUILDING INSPBCTION <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: 5~-794S <br /> <br />Dste: <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />lob No. <br /> <br /> FOR OWNE~ INSTALLATIONS <br />l~ope~y Owner O~le~g print) <br /> <br />Mailing Addreas [ Phone <br />City/State/Zip <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 />4. FEB SCHEDULH (Completa and euta' total i~ Al below) <br /> Numb~r of Inst~tions p~ p~nmlt alloyed ----] <br />fi. <br /> Rmidzntinl <br /> P~r <br /> Unit <br />5~evie~ineinded: ltatas Co~t(each) Sum I <br />10O0 sq. ti. or less $85.00 4 <br />Ea& additional 500 sq. ft. <br /> ~ portion th~.of $15.00 <br />Limitad Energy $20.00 __1 <br />Each Manufactured H~ne or Modular <br /> Dwelbug Service or Feode~ ~ $40,00 2 <br /> <br />B. ~vi~es o~ Feed~s (Does not include bran0h ci~cuit~, se~ section D) <br /> <br /> Inatallation, Air,cation c¢ R~oe. afion <br /> 200 amoa or lesa <br /> 201 amp~ to 400 aml~ <br /> 401 amps ~o 6O0 aml~ <br /> ~01 mups to 10O0 amps <br /> ~r 10(30 amps or volta <br /> Reconnect only <br /> <br />C. Temporary 8~vic~/Feed~r~ <br /> Ingallation, Altztatlcn, or Rek~ation <br /> 200 amps or less <br /> 201 amp~ to 400 amps <br /> 401 amps to 600 aml~ <br /> Over 600 amps or 10O0 volta <br /> <br />D. Branch Circuits <br /> Nmv, AIt~ratinn~, e~ Extension Pe~ Panel <br /> a) ~he fee for branch circuita with <br /> <br />2.O0 <br /> <br />$60.O0 <br />$1O0,00 <br />$t30.O0 <br />$300.00 <br />$40.O0 <br /> <br />$35.00 2 <br />SS0.00 2 <br /> <br />$35.O0 <br />$2.O0 <br /> <br />E. Migdlan~s (Se~vlee ~ F~d~ No~ l~d~) <br /> ~ch pump ~ iMgatbn c~l= ~.~ 2 <br /> <br /> ~er ~= allowable ~ any of~e <br /> above, ~r ~pg~ion <br /> <br /> Pack of 10 l~eh ~ $5.~ ~ch $~.~ <br /> <br /> (~ required by ~ildi~ <br /> A~ ~elYmg Elec~cal F~ sq. fi, x $.~8 = <br /> <br />A2. Add5% suzchar~ (,05 xAl) <br /> S~ <br /> ~ubtotal $.__ <br /> <br /> (See. 3), if required $.__ <br />C. Inv~tigation Fee (if required) $___ <br />D. Reia~pection F~e ($25.00) $.__ <br /> TOTAL AMOUNT DUE $~'~t'~" ~ <br /> <br />MC 15-34 1/96 <br /> <br /> <br />