Laserfiche WebLink
FOR CITY VALIDATION[ <br />Rec~iwd by: I <br />Date: <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />1 <br /> 1. LOCATION OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSP~ECTION <br /> <br /> PERMIT NO: <br /> <br /> Date: <br /> <br /> 24 hr. Inspection Lln~373-4427 <br /> Office: pho~J~m - 4:30pm <br />ELECTRICAL PERMIT APPLICATION <br />Please complete all Sections, I through § <br /> <br />~lll DING <br /> <br />/obAddrcss ~ t.~ 3 ~ ~ ~"~VX~oOC_~X <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STAR~ED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner ~]ease <br /> <br />. ~ng Ad~s <br /> <br />' City/S~t~p <br /> <br />Owner's Signature: <br /> <br />3. PLANREVII~W SIiCTION <br /> <br />IMarion 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 />Issued by: <br /> <br /> ~4~ F]~ SCHEDULE (Complete and onte~ total in A ! below) <br /> ~.~. ,,~,~[~':defltial Fec Dnit Number of Impeetions p~ permit allowed -=~ <br />;pE _~gMin~d~d: ttem~ C~t(eaeh) Sum I <br /> 1000 sq. ft. or le~ $85.00 4 <br /> Each additional 500 sq. ft. <br /> ~ posen thereof $15.00 <br /> Limited Energy $20.00 <br /> Each Manufactured Home or Modular <br /> Dwelling Service or Peede~ $40.00 2 <br /> <br /> B. t~r~ o~ F~de~s (De~ not include Inn~h ~reuita, s~e section D) <br /> 201200Installati°n'amps to 400 ampsamps or lessAlte~atlm~ er Relocation ~°~ $60.00550'00 ~.~ <br /> 401 amps to 600 ~mps $100.00 <br /> 601 amps to 1000 amps $130.00 <br /> Over 1000 amps or volte $~00.00 2 <br /> Reconnect only $40.00 2 <br /> <br /> C. Temp~ary <br /> Installation, Alteration, er Rolo~atinn <br /> 200 amps or leas $35.00 2 <br /> 201 amps to 400 amps $40.00 2 <br /> 401 amps to 600 amps $80.00 2 <br /> Over 600 ~npe or 1000 volts <br /> ~ "B~ above <br /> D. Branch Circuits <br /> Nmv, Altu~ations, er E~nsion p~ Panel <br /> a) The fee for branch circuits ~ <br /> pumhaae of seawice of feeder the ~0 qO~" <br /> Each branch circuit $ 2.00 <br /> <br />b) The fee for branch cit~ulte without <br /> <br />blh~ellan~s (Service er Feed~ Not Ineluded) <br /> <br />$35.~ <br />$2.~__ <br /> <br />$40.00 2 <br />$40.00 2 <br /> <br /> Each pump or ircigatinn circle <br /> Each sign or outline lighting <br /> Signal cimuit(s) or a limited energy <br /> psneL, alt ~eli~-~ or extemion <br />F. l~ach additional Iflape~tion <br /> Over the allowable in any of the <br /> above, per Inspection <br />O. Min~ Installation Labels <br /> Pack of 10 labels @ $5.00 each <br /> (sold only to e/ectricM co~tt~ctots) <br />H. Othe~ <br /> <br /> (As required by Building O~cia/9 <br /> Aurora Dwelling Electrical Fee <br /> Dwelling Permit Label <br /> <br />MC 15-34 1/96 <br /> <br />N/C <br /> <br />$35.00 -- <br /> <br />S IqO'- <br />S.__ <br /> <br />$ <br />$ <br />$__ <br /> <br />FEES <br />Al. Emer totaloffees from See. fi4 <br />A2. Add 5% su~harge (.05 x Al) <br /> Eabtotal <br /> <br />B. Emer25% of lineAl for Plan Review <br /> (Sec. 3), if required <br />C. Inve~tigalion Pee (if requited) <br />D. Reimpection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br /> sq. fl, x $.068 =__ <br /># of Labels <br /> <br /> <br />