Laserfiche WebLink
| Received by: ] <br />/Dat~: I <br /> <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 3734427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all .qections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERM]TS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 1~0 DAYS OF ISSUANCE OR IF <br /> WORK lS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Electrical Contractor <br />Address <br />Phone// Fax~ <br />Property Owner Phoneff <br />Contractors License NO. <br /> <br />Contractor's Board Rog No. <br /> <br />Signature of Supervising Electrician <br /> <br />Supervisor's License No, <br /> <br />J Job No. <br /> <br />Phenol <br /> <br />FOR OWNt~ INSTALLATIONS <br /> <br /> 3. PLANRBVIBW SECTION <br /> <br /> Marion County does not require a plan review. <br /> We will pwvide 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 />4. FtlR .~2HItDULII (Complet~ and emer total in Al b~low) <br /> Number of Inspections per permit allowod <br /> Per <br /> Unit <br />&x'vioo lndudod: Items Cost (each) Sura <br />10O0 sq. ft. or less $85.00 4 <br />Each additional 500 sq. ft. <br /> or pelion thereof $15.0O -- <br />Limited Energy $20.00 __1 <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 2 <br /> <br /> 200 amps or less [ $50.00 <br /> 201 amps to 400 amps $60.00 -- <br /> 401 amps to 600 amps $10O.00 -- <br /> 601 amps to 1000 ampe $130.00 <br /> Over 100O amps or volta $300.00 <br /> Reconnect only $40.00 <br /> <br />C. Temporary Sucviees/Peeders <br /> <br /> 200 amps or less $35.00 <br /> 201 amps to 400 amps $40.00 -- <br /> 401 anps to 600 amps $80.00 -- <br /> <br /> a) The fee for branch ¢irculls ~ <br /> ~urcbese of service of feeder fee <br /> EaCh branch circuit 7 $ 2.00 -- <br /> <br /> b) The fe~ for branch circuits without <br /> <br /> First branch cimult $35.00 <br /> Each additional branch circuit $ 2.00 <br /> <br />E. Miscellaneous (Service or Feeder Not Inoluded) <br /> Each pump or irrigation circle <br /> Each sign or outline lighting <br /> Signal circuit(s) ora limited energy <br /> panel, alteration or exiemion <br />F. Each additional Inspeetinn <br /> Over tho allowable in any of the <br /> above, per Inspection <br />O. Minor ]nntallation Labels <br /> Pack of 10 labels ~ $$.00 each <br /> (sold only to electrical comractors) <br />H. Othe~ <br /> (A~ required by Bnildin~ O~cial) <br /> Aurora Dwelling Electrical Fee <br /> Dwelling Permit Label <br /> <br />$40.00 <br /> <br />$35.00 -- <br />$50.0O <br /> <br />--xq. fi. x $.068 =__ <br />#0fLabals N/C <br /> <br />2 <br />2 <br />2 <br />2 <br />2 <br />2 <br /> <br />5. FEES <br /> A I. Enter total of fees from Sec.//4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br />Subtotal <br /> <br />B. Eater25% of lineAl forPlanReview <br /> (Sec. 3), if required <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUB <br /> Receipt No. <br /> <br /> <br />