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FOR CITY VALIDATION <br />Re,civil by: <br />Date: ] <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CEN[ER <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 />FAX: 588-7948 <br /> <br />ELECTRICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Fax// <br /> <br />Phone# <br /> <br />Electrical Contractor <br />Address <br /> <br />Phone# <br /> <br />Pr/~erty Owner <br /> <br />No. <br /> <br />Contractors Licen~ No, <br /> <br />I Phonelt <br /> <br />Contractor's BoardReg No. <br /> <br />Signature of Supervising Electrician <br />Supervisor's Lice~.se No. <br /> <br />2B. FOR OWNER INb"rALLATIONS <br /> <br />Mailing Addre~ <br /> <br /> 3. PLANREVIBW 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 />MC 15-34 1/96 <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and ente~ total in Al bdow) <br /> Ntunber of lnapectinns p~r permit allowed <br /> R~sidentinl <br /> Per <br /> Unit <br /> <br />1000 sq, ft. or less $85.00 <br />Each additional 500 sq. ft, <br /> or portion thereof $15.00 <br />Limited Energy $20,00 <br />Each Manufactured Home or Modular <br /> Dwelling flervice or Feeder [ $40.00 <br /> <br />Installation, Alteration or Relocation <br />200 amps or less $50.00 2 <br />201 amps to 400 amps $60.00 2 <br />401 amps to fi00 amps $100.00 2 <br />601 amp~ to 1000 ~nps $130.00 -- 2 <br />Over 1000 amps or volts $300,00 2 <br />Reconnect only $40.00 2 <br /> <br />b) The fcc for branch circuits without <br /> <br />First branch circuit <br />Each additional branch circuit <br /> <br />$35.00 <br />$2.00 <br /> <br />E. Migdhn~ous (8~vie~ or Feeder Not lndud~l) <br />Each pump or inrigation circle $40.00 2 <br />Each sign or outline lighting $40.00 2 <br />Signal circuit(s) or a limited energy <br />panel, alteration or extemion M0.00 2 <br />F. Each additional Inspection <br />Over the allowable in any of the <br />above, per Inspection $35.00 <br />O. Minor Installation Labels <br />Pack of 10 label~ @ $5,00 each $50.00 <br />(sold only to electrical contractors) <br />H. Other <br />(As required by Building O~ciaD <br />Aurora Dwelling Eleclrical Fee <br />Dwelling Permit Label NIC <br /> <br />--sq. fi. x $.068 = <br /># of Labels <br /> <br />5. FEES <br />A 1. Enter total of fees fwm See. #4 $.__ <br />A2. Add 5% surcharge (.05 x Al) $.__ <br /> Subtotal $.__ <br /> <br /> B. Eater 25% of line A 1 for Plan Review <br /> (See. 3), if requi~d $___ <br /> C. Investigation Fee (if required) $ <br /> D, Reinapection Fee ($25.00) $ <br /> <br /> TOTAL AMOUNT DI,~ $ <br /> Receipt No. <br /> <br /> <br />