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FOR CITY VALIDATION <br />Received by:. <br />Dst©: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> 255 Church StNE· 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: 588-7948 <br /> <br /> ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />lob Address <br /> <br />lob De,cfi tiom <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EX~IRE IF WORK IS NOT <br />STARTED W1TH]N 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />~lectrical Contractor ~ <br />Address <br /> <br />2B. FOR OWNI~ INSTALLATIONS <br /> <br />Properly Owner ~o/e~s~ pri~) <br /> <br />~ili~ Add~a <br /> <br />Clty/S~a~.~Zip <br /> <br />Owner's Signature: <br /> <br />3. PLAN REVIEW 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 /> PERMff NO: <br /> Date: <br /> Issued by: <br /> <br />4. FEE SCHI~DULE (Complete and enter total~Al below) <br /> <br />A, R~identinl P~ Unit Number of Inspections <br />~vie~ Ineludad: Items Cost (each) Sum <br />1000 sq. fl. or less $85.00 <br />~ach additional 500 sq. fL <br /> <br />200 amps or le~a $50.00 <br />201 amps to 400 amps $60.00 -- <br />401 amps to 600 amps $100.00 -- <br />601 amps to 1000 amps $130.00 -- <br /> <br />Reconnect only $40.00 -- <br /> <br /> 200 amps or less $35.00 -- <br /> 201 amps to 400 amps $40.00 -- <br /> <br /> a) The fee for branch ckcui~s ~ <br /> ourchase of service of feeder fee <br /> Each branch circuit $ 2.00 -- <br /> <br />b) The fee for branch circuits without <br /> purchase of service or feeder fee <br />First branch ciredit <br />Each additional branch circuit <br /> <br />$35,00 -- <br />$ 2,00 -- <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 />E. Miscellaneous (Service c~ F~d*r Not Included) <br />Each pump or irrigation circle $40.00 -- <br />Each sign or outline lighting $40.00 <br />Signal circuit(s) or a limited energy <br />panel, alteration or extension $40.00 <br />F. Bach additional lnapaotion <br />Over the allowable in any of the <br />above, per lnsgnction $35.00 -- <br />O. Minor Installation Labels <br />Pack of 10 labels @ $5.00 each $50.00 -- <br />(sold only to electrical contractors) <br />H. Other <br /> (As required by B~ildit~ Offwial) <br /> Aurora Dwelling Electrlea[ Fee sq, fl. x $.068 =__ <br /> Dwelling Permit Label # of Labels. <br /> <br />N/C <br /> <br />5. FEES <br />Al. Emer total of fees from See.//4 $__ <br />A2. Add 5% suroharge (.05 x Al) $__ <br />Subtotal <br /> <br /> B. Enter25% of lineAl for Plan Review <br /> (Sec. 3), if r~quip*d <br /> C. Investigation Pc* (if r~quired) <br /> D. Reinsgnclion Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE $.__ <br /> Receipt No. <br /> <br />MC 15-34 1/96 <br /> <br /> <br />