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~, MARION COUNTY BUILDING INSPt~_ <br /> <br /> FORCITYV ID ON' 285 Chu~ St NE Room132 I]~RM~NO: ~llll <br /> <br /> ~ . ~ D~e: <br /> Omce: Phone 588~147 8:00am- 4=30pm . MAR~N C0UNW <br /> <br />ELECTRICAL PERMIT APPLICATION <br />Please complete al~ Sect/one, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFI~RABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR tS0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />I Conlractnr'. License No. <br /> <br />Contractor's Board Reg. Ho. ,~9 ~ - ~/c'~ ~ ~ob~ <br />Signature of Supervising Ele~tricima ~ <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner ~leas~ pri~t) <br /> <br />Mailiag A~ld~s { l~,~ae <br /> <br />City/Slate/Zip <br /> <br />Owner's Signature: <br /> <br />3. PLANREVIIiW SRCTION <br /> <br />Marion County does not require a plan review. <br />We will pwvide plan review service if you complete <br />Section 5B and subreit two (2) sets of plans and <br />specifications with this application. <br /> <br />4. FEE SCHEDULE (Complete and enter total in A 1 below) <br /> Ntanber of lnspectinlm <br /> per permit <br /> allowed <br />A. Recldential Per Unit · <br />Service Included: Items Cost (each) Sum I <br />I000 sq. fl. or less $85.00 4 <br />Each additional 5~0 sq. ft. <br /> or portion ~hereof $15.0O <br />limited Energy $20.00 l <br />Each Manufactured Home or Modular <br /> Dwelling Service or Feeder $40.00 2 <br /> <br />B. Seevine~ or Feeder a (Do~s not include branch circuits, see section D) <br /> <br /> $50.00 2 <br /> <br />$100.00 2 <br />$130.00 2 <br />$$0O.00 2 <br />$40.00 -- 2 <br /> <br />$35.00 2 <br />$40.00 2 <br />S80.0O 2 <br /> <br />s zoo <br /> <br />$35,00 <br />$ 2.oo <br /> <br />Miscellaneous (~ervioe or Foede~ N~ Included) <br />Each pump or ir~gation circle $~.~ ~ 2 <br />~ch si~ or outline ligh~g ~.~ ~ 2 <br />Sign~ cimuit(s) or a I~itcd en~ <br />~cl, alt~fion or exlamion ~.~ 2 <br /> <br />Over th~ allowable in any of ~o <br />above, per Inspection $35.~ ~ <br /> <br />Pack of 10 labels ~ $5,~ ~ch $50.~ <br />(sold o~ to eleotrical co~racWrs) <br /> <br />(~ reqni~d by ~ilding O~tci~O <br />Amra ~elling Electrical F~ Jq. fi. x $.068 = ~ <br />Dwelling Pemit ~bel g of ~la ~[~ <br /> <br />5, FBE8 <br /> A 1. Enter total of fees from Se~. fi4 <br /> A2. Add 5% surcharge 605 x Al) <br /> <br />Subtotal <br /> <br />B. Enter 25% of line A 1 l'or Plan Review <br /> (Sec. 3), if required <br />C. lnvestigation~ee (if required) -/ -~1%~ <br />D, Reinspection Fee ($25.00) ~-(~ ~ ~ <br /> <br />Receipt No. ~,~_~OTAL <br /> AMOUNT <br /> DUB <br /> <br />MC 15-341/96 <br /> <br /> <br />