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MARION COUNTY BUILDING INSPECT~N <br /> <br /> 285 Church St NE Room 132 <br />FOR CITY VALIDATION Salem. OR 97301 <br /> <br />Date' <br />· { 24 hr. Inspection Line 373-4427 <br /> OEice' Phone 588-5147 8'00am 4'30pm <br /> <br />Please complete all Sections, I through 5 I <br /> <br /> A. <br /> R~id~ntial <br /> Unit <br />1. LOCATION OF I~$TALLATION <br /> <br />pERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPFJqDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Parkin Electdc, Irtc. 20250 S Molalla Ave, <br />Oregon City, OR 97045 503-657-4958 <br />Contractors License #: 34-4C <br />Supervisor: 4241-S <br />Contractors Board Reg #: 35151 <br /> <br />] S~pervisor's License No. [ Phone# <br />2B. FOR OWNER INSTALLATIONS <br />Prop-~ty Owner (ple#~pri~t) <br /> <br /> I <br />M~iling Addrei8 I <br /> <br />Owner's Signature: <br /> <br />3. PLAN RBVIBW SBCTION <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 />1000 sq. fl. or less $85.00 4 <br />Each additional 500 sq. ft. <br /> or potion thereof $15.00 <br />Limited Energy $20.00 1 <br />Each Manufactured Home or Modul~ <br /> Dwelling Service or Fee&r I <br /> <br /> Each branch circuit $ 2.00 <br /> <br />b) 2he fee for branch circuits wi~ <br /> purchase of service or feeder <br />First branch circuit <br />F~ch additional brach eiguit <br /> <br />E. Mi~ellan~ous (Se~vlcoor F~de~ No~ inolud~d) <br /> Each pump or ~gation c~le <br /> ~ch si~ or oufl~e li~ <br /> S~ ci~uit(s) or a I~t~ cn~ <br /> panel, alteration or exte~ion <br /> <br /> Over lhe allowable in any of ~e <br /> above. ~r hspeetion <br /> <br /> P~ck of l0 labels ~ $5,~ ~ch <br /> <br /> (~ mqui~d by Buildi~ <br /> <br />$35.00 .- <br />$ 2.0O -- <br /> <br />:MO.O0 .... 2 <br />$40.00 -- 2 <br /> <br />$40,00 -- 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br /> sq. fl. x $,068 = <br />#ofLal~D. NIC <br /> <br />5. FEES Al. Enler total of fees from Sec. #4 <br /> A2. Add 5% su~harge 605 x Al) <br /> <br />Subtotal <br /> <br />B. Enter 25% of Eno Al for Plan Review <br /> (See. 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 />s ~t25- <br /> <br />MC 15-341/96 <br /> <br /> <br />