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FOR CITY VALIDATION <br />Received <br />I~te: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> 285 Church StN~ ' Ro<nn 132 <br /> Salem, OR 97301 <br /> <br /> Z4 hr, Inspection Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />IELECTRICAL PERMIT APPMCATION I <br />Please complete all Sections, I through 5 <br /> <br />FERMYI'S AR~ NON-TRANSI~aRABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR I~[~TALLATION ONLY <br /> <br />P~73-3307 I= <br /> <br />2B. FOR O~ IN~FALLAT1ON8 <br /> <br /> P~peny Ow~'r (pl~ttprmt) <br /> /V~iling Addn:~ I Phone <br /> City/Slat~ <br /> Owner's Sig.~ur~: <br /> <br />3. FLANRB¥1BW 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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issuod by: <br /> <br />200 amps oc le~ $50.00 <br />201 amps to 400 amps $60.00 <br />401 amps to 600 amp~ $100.00 <br /> <br /> 201 amp~ to 400 smp~ $40.00 <br /> a) The fee for branch circl~ls ~ <br /> <br /> b) The fee fo~ b~nch circuits with~m <br /> <br /> Fi~l branch c~mt I <br /> ~h addit~ b~h ci~Uil <br /> <br />E. Mi~n~s (~ F~ N~ In~) <br /> <br /> (~d ~ly ~ el~tctctl <br />H. Oth~ <br /> <br />s..0o3-S <br />$2.~0 ~ <br /> <br />$4O.OO 2 <br />S4000 2 <br /> <br />S40.00 2 <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br />sqfix$O~= <br /> <br />A 1. ~ller Iotnl of £ee~ fiom Sec. #4 <br />A2. Add 5% aumhal~e (.05 x Al) <br /> <br />B. ~r25% of line Al for Plan Review <br /> <br />C Inv~figal~n ~ <br />D. Re~p~t~n ~e ($~.~) <br /> <br />s---'J-FF5 <br /> <br />MC 13.34 1/96 <br /> <br /> <br />