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FOR CITY VALIDATIONI <br />R~eiv~l b~ [ <br />Date: . ] <br /> <br />. MARION COUNTY <br />· BUILDING INSPECTION DIVISION <br /> 3150 LANCASTER DR NE - SUITE C <br /> SALEM OREGON 97305-1398 <br /> <br /> 24 hr. Inspection Line 373.4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />IELECTRICAL PERMIT APPLICATION I <br />Please complete ail Eections, I through 5 <br /> <br />1. LOCATION OF R~ISTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIR~ IF WOILK IS NOT <br />STARTED ~ 180 DAYS OF ISSUAHC~ OR IF <br /> WORK IS eUSPENDIiD FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> FOR O~ INSTALLATIONS <br /> <br />Pmpeay Owner <br /> <br /> City/StateTZip <br /> <br /> Ownces Signature: <br /> <br />3. PLANRE~ 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 REd <br /> specifications with this application,,. <br /> <br />MC 13-341/96 <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> FI~]~ SCI~I~U'L~ (Complete and enter total itt A 1 b~low) <br /> Ntmaber of Inspections p~ gcrmlt ellow~l -~ <br /> Residential <br /> Unit <br /> ~ In~d~: ~ ~t (~ch) S~ <br />1~ sq. ~ ~ ~a $~.~ 4 <br /> <br />~ch M~ufac~ H~e or Mo~l~ <br />~li~g ~i~ ~ ~ ~.~ 2 <br /> <br /> ~ ~ or 1~ $~ 2 <br /> 201 ~ to~ ~ $~.~ ~2 <br /> <br /> ~1 ~m 1~ $1~ ~2 <br /> ~r 1~ ~ or volta ~.~ ~ 2 <br /> R~t only ~,~ ~ 2 <br /> <br /> ~1 ~to~ ~.~ 2 <br /> ~er ~ ~ or I~ ~l~ <br /> <br /> ~ b~n~ c~uit <br /> <br /> b) Thc fe~ for bomch cixculta without <br /> <br /> Fa'st branch circldt <br /> Each additional branch circuit ~.~ <br /> <br />E. Miscellaneou$ (~rvlco ~r I:eedec Hot Included) <br /> Each pump or irrigation circle <br /> Each alga or outhne lighting <br /> Sig~aI circuit(s) or a limiled energy <br /> panel, altevatlon 0~' extension <br />F. Each additional In~peotion <br /> Over the aliowable in any of the <br /> above, l~r Inspextion <br />O. Mi~or InstaHatlon Labels <br /> Pack. of tO labels @ $5.00 each <br /> (sold o~ly to el~otde$1 co~acactors) <br />H. Othec <br /> <br /> (As required by B~Edi~g 0~¢~1) <br /> <br /> Dw~lllng Pea'mit Label <br /> <br />$ 2.~0 <br /> <br />$4O.00 2 <br /> <br />$35.00 -- <br /> <br /> sq. f~ x $.068 = <br /># Of La~ls mC .... <br /> <br /> <br />