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FOR CITY VALIDATION <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <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 /> <br />ELECTRICAL PERMIT APPLICATION [ <br />Please complete all ~ections, I through 5 <br /> I <br />1. LOCATION OF INSTALLATION <br /> <br />'::J 7e 3 <br /> <br />PERI. TS ARE NON-TRANS FERABL~ AND EXPIRE IF WORK IS NOT <br />STARTED ~ 180 DAYS OF ISSUANCE OR IF <br /> WORK 18 SUSPENDED FOR 180 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />Fa~ <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 />AfC 1.5-34 1/96 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FBB $Cltl]DULIt (Complete and enter loCal ia A { below) <br /> <br /> Inmallation. AIt~aton <br /> 200 nmp~ or <br /> <br /> 200 ~m[~ or leu $35.00 <br /> <br />b) The fex for branch ci~:oil$ ~fllhout <br /> IB~xh~c~of service or feeder fee <br />First branch c~rcuit <br />Each additional branch cireui! <br /> <br />$35.~ <br />$2.~ <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br />$35.00 <br /> <br />____.¢q ftx $ 068 = -- <br /># of Imbeh N/C - <br /> <br />5. FEES <br /> Al. Eater iota{ of fee~ fo31n Sec. #4 <br /> A2. Add 5% aurchn~ (.05 x Al) <br /> ~bt~a{ <br /> <br /> B. ~ler 25% of {~ A I for P~n Review <br /> (Sec. 3). if ~qui~d <br /> C Investigat~ ~ (if~q~) <br /> D. Re.pecan Fee (~5,~) <br /> <br /> ~T~ ~OU~ D~ <br /> <br /> <br />