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/ MARION COUNTY <br /> !BU.D U NSPECT ON ,WS O. '. qq-- <br /> 3150 LANCASTER DR NE - SUITE C <br /> FOR CITY YAI..,IDATION] SAI~EM OREGON 97305-1398 PERMIT NO: <br /> Received by:~ <br /> <br />ELECTRICAL PERMITAPPLICATI~N~ ~UL...~ 5 I! ~? - <br /> Please complete ail Sections, lthroug115 1~ 4. tT~'R ~CIqFl~UL~ (Complete and enter lolal in Al below) <br /> <br /> LOC 'demlal t~c Unit <br />t. ATIONOF]I~'EI'ALLATION BUILDING INSPE ~[=~d~. >.~ c~,(~) <br /> 1.000 sq. fl. or l~a $85.00 4 <br /> <br /> or poflion ~e~eo f $15.00 <br /> Limited Energy $20.00 1 <br /> Each Manufactamd~Hom¢ or M_~odu[az <br /> Dwellin~ Service or Feedex t $40.00 <br /> 2 <br /> <br />PERMITS ARE NON-TRANSi:F~,B[.~ AND ~ IF WORK IS NOT <br />STARTED ~ 180 DAYS OF ISSUANC~ OR IF <br /> WORK IS SUSPENDED FOP. 180 DAYS, <br /> <br />C. Temp~ary ~rvice~eedecs <br /> <br />2A. CONTRACTOR ]I~ISTALLATION ONLY <br /> <br />Parkin Electric, Inc. 20250 S Molalla Ave. <br />Oregon City, OR 97045 503-657-4958 fax: 557-1059 <br />Contractors License #: 34-4C exp. 10-01-97 <br />Supervisor: 4241-S exp. '10-01-98 <br />Contractors Board Reg#: 35151 exp. 10-12-98 <br /> <br />200 aml~ or 1~ $35.00 <br />201 amp to 400 aml~ $40.00' -- <br />401 amps to 600 anl~ $80.00 <br />Ov~ 600 am[~ or 1000 vola <br /> <br />a) Ta~ fee for branch c~uit~ <br />F~ch branch dmuit $ ZOO <br /> <br />Metro # 2416 ex~p. 11-01-97 <br />Su~rf~0r'~ ~ NO. ~ <br /> <br />2B. FOR OWN][R II~TALLATIONS <br /> <br />Property Owner (ple~t~pt'ittt) <br /> <br />Mailing Addr~as <br /> <br />City/Slate/Zip <br /> <br />Owner's $ignatuvc: <br /> <br />3. PLAN REVIle' SECTION <br /> <br />Marion County does not require a plan review., <br />We will provide plan review service if YoU complete <br />Section 5B and subn~it two (2) sets of phns and <br />specifications with this application. <br /> <br />MC t$-J4 1/96 - <br /> <br />b) *lbo f~ for branoh circu/~ withoul <br /> <br />Fi~t branch oimult <br />Each additional brmcli ¢imuit <br /> <br />$35.~ <br />$2.~ <br /> <br />$40.00 2 <br />$40J00 2 <br /> <br /> Each pump or izrigation circle <br /> Each sign or outllne lighfiag <br /> Signal ci~ult(s) or a limited <br /> <br />F. Eae. h addltionat lnspeetlon <br /> Ov~ I1~ allowable in any of tho <br /> ahoy., per [mpeclion <br />O~ Miner lnst~lhtion l~bels <br /> P~:k of 10 lal~s ~ $5,00 each <br /> (~old oaly Io d~m'~! ¢or~tr~¢wc <br />H. Other <br /> (,4~ r~ui,'ed by Bu~ldin~ O~i~l) <br /> Aurora Dwelling Elcc~cal Fee <br /> <br />FEES <br />Al. Enter total of fee~ flora Sec. fi4 <br />AZ Add 5% au~har~ (.05 x Al) <br /> <br />$35.00 <br /> <br />$50.00 <br /> <br /> sq. fl. x $.068 =__ <br /># df t.a~b N/C <br /> <br />2 <br />2 <br />2 <br /> <br /> · B. Enter 25~, of lineAl for Plaa Rcvlew <br /> (s~.3). ir r,.qui~ $ __ <br /> <br /> D. P,~imp~llo~F~ ($25.00) $ __ <br /> <br /> TOTAL AMOUNT D[~ $ <br />. R~mipt <br /> <br /> <br />